Treatment of ventricular arrhythmias in the elderly.
Underlying causes of ventricular tachycardia (VT) or complex ventricular arrhythmias (VA) should be treated if possible. Antiarrhythmic drugs should not be administered to treat asymptomatic individuals with complex VA and no heart disease. Beta-blockers are the only antiarrhythmic drugs that have been documented to reduce mortality in patients with VT or complex VA. Radiofrequency catheter ablation of VT has been beneficial in treating selected patients with arrhythmogenic foci of monomorphic VT. The automatic implantable cardioverter-defibrillator (AICD) is the most effective treatment for patients with life-threatening VT or ventricular fibrillation. Patients with AICDs should be treated with biventricular pacing, not with dual-chamber rate-responsive pacing at a rate of 70/min. Patients with AICDs should also be treated with beta-blockers, statins, and angiotensin-converting enzyme inhibitors or angiotensin blockers.
Aronow
Wilbert S
WS
Cardiology Division, Department of Medicine, New York Medical College, Valhalla, New York 10595, USA. wsaronow@aol.com
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D017180:Tachycardia, Ventricular / Q000628:therapy*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors