By G. Turitto (auth.), Antonio Raviele MD (eds.)
The topic of cardiac arrhythmias is of useful relevance. a number of arrhythmias are present in varied medical events, reminiscent of untimely complexes in fit members, supraventricular tachyarrhythmias in sufferers with Wolff-Parkinson-White snydrome, atrioventricular block, and ventricular traumatic inflammation in cardiopathic stipulations, specially in sufferers with ischemic ailment. themes of significant curiosity are mentioned during this quantity: malignant ventricular arrhythmias, unexpected demise, automated implantable cardioverter defibrillators, syncope, present symptoms for pacing remedy, radiofrequency catheter ablation, flutter, and atrial fibrillation.
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Ryden L, Ariniego R, Amman K et al (1983) A double blindtrial of metoprolo1 in acute myocardial infarction. Effects on ventricular tachyarrhythmias. N Engl J Med 308: 614-618 10. Hjalmarson A (1994) Empiric therapy with beta-blockers. PACE 17: 460-466 11. Meredith IT, Broughton A, Jennings GL, Esler MD (1991) Evidence of a selective increase in cardiac sympathetic activity in patients with sustained ventricular arrhythmias. N Engl J Med 325:618-624 Conclusions Beta blockers. These should be considered the drugs of choice in patients with idiopathic VT.
J Am Coli Cardiol 8: 959-965 13. Brodsky MA, Allen BJ, Luckett CR, Capparelli EV, Wolff LJ, Henry WL (1989) Antiarrhythmic efficacy of solitary betaadrenergic blockade for patients with sustained ventricular tachyarrhythmias. Am Heart J 272-280 14. Hallstrom AP, Cobb LA, Yu BH, Weaver WD, Fahrenbruch CE (1991) An antiarrhythmic drug experience in 941 patients resuscitated from an initial cardiac arrest between 1970 and 1985. Am J CardioI68:1025-1031 15. Steinbeck G, Andresen D, Bach P, Haberl R, Oeff M, Hofmann E, von Leitner E-R (1992) A comparison of electrophysiologically guided antiarhythmic drug therapy with beta-blocker therapy in patients with symptomatic sustained ventricular tachyarrhythmias.
The conclusions of these retrospective and nonrandomized studies (60-62) are that amiodarone can be used safely and successfully after 5 years in approximately half of the patients with VT or VF and that the incidence of sudden death is relatively low after the first year (3% per year). Finally, few clinical and laboratory parameters can identify patients at high risk. The superiority of amiodarone treatment in comparison to class I agents was demonstrated by CASCADE (Cardiac Arrest in Seattle: Conventional versus Amiodarone drug evaluation), a prospective study which included 228 survivors of cardiac arrest: 113 were randomized to empirical administration of amiodarone, and 115 to an electro physiologically guided conventional treatment (quinidine and procainamide in most cases) (63,64).