[Therapeutic indications, principles and guidelines of differential drug therapy of cardiac arrhythmias].
Several arrhythmias have different causes and different needs for therapy. Indications for antiarrhythmic therapy is related either due to an increased mortality risk, predominantly if ventricular arrhythmias are present, or due to a decreased quality of life, especially in supraventricular arrhythmias (SVA). In the past decades diagnostic and therapeutic methods were improved, many new antiarrhythmic drugs entered the clinical use and new devices came up. In general the number of therapeutic strategies increased up to the confusing present stage. Drug therapy of SVA is furthermore based on the use of calciumantagonists, beta-blockers and digitalis, with a smaller amount other class III and class I antiarrhythmic agents. Nevertheless new curative methods were developed like the various ablation-techniques, which gives the patient a tremendous chance to live without any attack and without any drug. In ventricular arrhythmias the hopes of a mortality reduction due to drug therapy could not be fulfilled, especially in the use of class I antiarrhythmic agents. They seemed to be proarrhythmogenic, which increases with the impairment of left ventricular function. Only class III antiarrhythmic drugs could reduce the increased mortality risk in specific populations. Consequently drug therapy in ventricular arrhythmias will be done cautiously under the aspects of proarrythmogenicity and the lack of convincing results, that the suppression-hypothesis works. Alternative therapeutic methods came up and should not withheld in high risk patients.
Weber
H
H
Klinischen Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Wien.
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D004562:Electrocardiography / Q000187:drug effects; D006801:Humans; D013610:Tachycardia / Q000145:classification / Q000188:drug therapy* / Q000209:etiology; D013617:Tachycardia, Supraventricular / Q000145:classification / Q000188:drug therapy / Q000209:etiology
D000889:Anti-Arrhythmia Agents
Therapieindikationen, Grundsätze und Richtlinien der medikamentösen Differentialtherapie von Herzrhythmusstörungen.