[Ventricular tachyarrhythmia. Drug therapy and evaluation of success].
In principle, all antiarrhythmic drugs (classes 1-3) are useful in the treatment of ventricular tachyarrhythmias. In special cases even Ca-antagonists (class 4) can be effective. Holter monitoring and programmed ventricular stimulation are clinical tools for predicting efficacy and controlling proarrhythmic effects. However, only in a limited number of patients are the prerequisites given for testing with one or the other method. Using long-term tape recording the suppression of ventricular salvoes by an antiarrhythmic drug seems to predict a good prognosis. In the electrophysiological lab complete or partial suppression of inducibility of the arrhythmias during programmed stimulation under antiarrhythmic treatment has a high predictive value as far as recurrence during follow-up is concerned. Using Holter criteria the efficacy of antiarrhythmic drugs is higher than with programmed stimulation. However, invasive electrophysiological testing has a higher sensitivity, i.e., a low rate of false-positive results. As the results of two newer studies question the value of both methods, a definitive answer of the problem of optimal control of antiarrhythmic therapy cannot be given today.
Seipel
L
L
Abteilung Innere Medizin III, Medizinische Universitätsklinik Tübingen.
Kühlkamp
V
V
D000889:Anti-Arrhythmia Agents / Q000145:classification / Q000627:therapeutic use*; D002304:Cardiac Pacing, Artificial; D016757:Death, Sudden, Cardiac / Q000209:etiology; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D006801:Humans; D012008:Recurrence; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000188:drug therapy / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
D000889:Anti-Arrhythmia Agents
Ventrikuläre Tachyarrhythmien. Medikamentöse Therapie und Erfolgsbeurteilung.