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Management of Ventricular Tachyarrhythmias: Title and subTitle BreakPart II FREE

Masood Akhtar, MD
[+] Author Affiliations

This article is one of a series sponsored by the American Heart Association.

Reprint requests to Mount Sinai Medical Center, PO Box 342, Milwaukee, WI 53201 (Dr Akhtar).


JAMA. 1982;247(8):1178-1181. doi:10.1001/jama.1982.03320330074035
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IN A previous issue of The Journal (1982;247:671-674), the role of drug therapy in the control of ventricular tachyarrhythmias was explored. The discussion of this therapeutic approach continues, and two other broad categories of management, "pacing" and "surgery," are examined.

Drug Therapy 

Role of Electrophysiological Studies and Serial Drug Testing.—  In recent years, electrophysiological studies have been used in an attempt to achieve a more objective therapeutic end point for the control of ventricular tachyarrhythmias.1 This has been made possible by the realization that ventricular tachyarrhythmias can be induced by programmed electrical stimulation (PES) in the controlled environments of the electrophysiology laboratory. This is particularly true of ventricular tachycardia (VT) and ventricular fibrillation (VF), both of which are generally reentrant in nature and, therefore, inducible with PES in a majority of patients who have experienced VT or VF or both. Programmed electrical stimulation is accomplished through electrode catheters (similar

REFERENCES

Horowitz LN, Josephson ME, Farshidi A, et al:  Recurrent sustained ventricular tachycardia: 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens . Circulation 1978;;58:986-997.
Akhtar M, Damato AN, Batsford WP, et al:  A comparative analysis of antegrade and retrograde conduction patterns in man . Circulation 1975;;52:766-778.
Ruskin JN, DiMarco JP, Garan H:  Out-of-hospital cardiac arrest: Electrophysiologic observations and selection of long-term antiarrhythmic therapy . N Engl J Med 1980;;303:607-613.
Wellens HJJ, Duren DR, Lie KI:  Observations on mechanisms of ventricular tachycardia in man . Circulation 1976;;54:237-244.
Mirowski M, Reid PR, Mower MM, et al:  Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings . N Engl J Med 1980;;303:322-324.
Khan MM, Logan KR, McComb JM, et al:  Management of recurrent ventricular tachyarrhythmias associated with Q-T prolongation . Am J Cardiol 1981;;47:1301-1308.
Guiraudon G, Fontaine G, Frank R, et al:  Encircling endocardial ventriculotomy: A new surgical treatment of life threatening ventricular tachycardias resistant to medical treatment following myocardial infarction . Ann Thorac Surg 1978;;26:438-444.
Josephson ME, Harken AH, Horowitz LN:  Endocardial excision: A new surgical technique for the treatment of recurrent ventricular tachycardia . Circulation 1979;;60:1430-1439.

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Horowitz LN, Josephson ME, Farshidi A, et al:  Recurrent sustained ventricular tachycardia: 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens . Circulation 1978;;58:986-997.
Akhtar M, Damato AN, Batsford WP, et al:  A comparative analysis of antegrade and retrograde conduction patterns in man . Circulation 1975;;52:766-778.
Ruskin JN, DiMarco JP, Garan H:  Out-of-hospital cardiac arrest: Electrophysiologic observations and selection of long-term antiarrhythmic therapy . N Engl J Med 1980;;303:607-613.
Wellens HJJ, Duren DR, Lie KI:  Observations on mechanisms of ventricular tachycardia in man . Circulation 1976;;54:237-244.
Mirowski M, Reid PR, Mower MM, et al:  Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings . N Engl J Med 1980;;303:322-324.
Khan MM, Logan KR, McComb JM, et al:  Management of recurrent ventricular tachyarrhythmias associated with Q-T prolongation . Am J Cardiol 1981;;47:1301-1308.
Guiraudon G, Fontaine G, Frank R, et al:  Encircling endocardial ventriculotomy: A new surgical treatment of life threatening ventricular tachycardias resistant to medical treatment following myocardial infarction . Ann Thorac Surg 1978;;26:438-444.
Josephson ME, Harken AH, Horowitz LN:  Endocardial excision: A new surgical technique for the treatment of recurrent ventricular tachycardia . Circulation 1979;;60:1430-1439.
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