Abstract:
:Despite advances in the treatment of congestive heart failure (CHF), the mortality rate continues to be high. A large number of the deaths are sudden, presumably due to ventricular arrhythmias. Complex ventricular arrhythmias are recorded in as many as 80% of patients with CHF, with nonsustained ventricular tachycardia occurring in 40%. The latter appears to be an independent predictor of mortality. Chronic structural abnormalities responsible for CHF may be the basis for the capability of a ventricle to support life-threatening arrhythmias, which are triggered by premature ventricular contractions. The pathogenesis of arrhythmias is multifactorial. Electrolyte abnormalities, ischemia, catecholamines, inotropic and antiarrhythmic drugs may worsen arrhythmias and increase susceptibility of a ventricle to sustained arrhythmias. Beta-adrenergic blockers and angiotensin-converting enzyme inhibitors have a beneficial effect. The role of various drugs in the pathogenesis and treatment of ventricular arrhythmias is discussed. The efficacy of antiarrhythmic therapy targeted to asymptomatic nonsustained ventricular tachycardia, in order to prevent sudden death, is controversial. Pharmacotherapy guided by electrophysiologic testing is the treatment of choice for patients who have manifest sustained ventricular tachycardia, but patients resuscitated from ventricular fibrillation may require automatic implantable cardioverter defibrillator.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Chakko S,de Marchena E,Kessler KM,Myerburg RJdoi
10.1002/clc.4960120910subject
Has Abstractpub_date
1989-09-01 00:00:00pages
525-30issue
9eissn
0160-9289issn
1932-8737journal_volume
12pub_type
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1980-08-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:1989-12-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:1999-11-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2005-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-12-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1987-07-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1992-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:1994-08-01 00:00:00
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更新日期:2020-12-01 00:00:00
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更新日期:1992-06-01 00:00:00
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pub_type: 社论
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更新日期:2004-02-01 00:00:00
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pub_type: 杂志文章
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1996-07-01 00:00:00
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pub_type: 临床试验,杂志文章,评审
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更新日期:2000-10-01 00:00:00
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