title: Adjuvant antiarrhythmic therapy in patients with implantable cardioverter defibrillators.
abstract: The risk of sudden cardiac death from ventricular fibrillation or ventricular tachycardia in patients with cardiomyopathy related to structural heart disease has been favorably impacted by the wide adaptation of implantable cardioverter defibrillators (ICDs) for both primary and secondary prevention. Unfortunately, after ICD implantation both appropriate and inappropriate ICD therapies are common. ICD shocks in particular can have significant effects on quality of life and disease-related morbidity and mortality. While not indicated for primary prevention of ICD therapies, beta-blockers and antiarrhythmic drugs are a cornerstone for secondary prevention of them. This review will summarize our current understanding of adjuvant antiarrhythmic drug therapy in ICD patients. The review will also discuss the roles of nonantiarrhythmic drug approaches that are used in isolation and in combination with antiarrhythmic drugs to reduce subsequent risk of ICD shocks.
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Eccles Outpatient Care Center, 5169 Cottonwood St, Suite 510, Murray, UT, 84107, USA, Thomas.bunch@imail.org.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
mesh_terms: D000638:Amiodarone / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001572:Benzofurans / Q000627:therapeutic use; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006801:Humans; D006827:Hydantoins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D048289:Imidazolidines / Q000627:therapeutic use; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D010627:Phenethylamines / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D013015:Sotalol / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D001572:Benzofurans; D006827:Hydantoins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D048289:Imidazolidines; D000451:Mineralocorticoid Receptor Antagonists; D010627:Phenethylamines; D010879:Piperazines; D013449:Sulfonamides; C086123:azimilide; D013015:Sotalol; C499879:celivarone; D000638:Amiodarone; C063533:dofetilide