Evaluation and treatment of ventricular arrhythmias

An update

P. L. McCollam, Robert Parker

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

An overall approach to evaluating and treating ventricular arrhythmias based on objective monitoring criteria is described. A clinically useful system classifies patients based on whether their ventricular arrhythmias are benign, potentially lethal, or lethal. Some clinicians believe that antiarrhythmic drug therapy improves survival in patients with potentially lethal arrhythmias. However, disappointing results from the Cardiac Arrhythmia Suppression Trial have led to a greater awareness of the potential adverse effects of antiarrhythmics. Various risk factors for arrhythmia-related death have been identified, such as the presence of frequent and complex ventricular ectopy, abnormal signal- averaged electrocardiography (SAECG) tracings, and poor left ventricular ejection fraction (LVEF). Antiarrhythmic drugs remain the primary mode of therapy for patients with recurrent symptomatic tachycardias. Antiarrhythmic drug efficacy has been evaluated by methods including symptom assessment, continuous ambulatory electrocardiographic monitoring (Holter monitoring), exercise testing, and invasive electrophysiologic testing. There may be an extremely wide range of effective serum concentrations for the class IA agents. Individual target concentrations of antiarrhythmic agents may be determined for individual patients and should assist the clinician in optimizing long-term antiarrhythmic drug therapy. The risk-to-benefit ratio of treatment should be weighed before antiarrhythmic drug therapy is begun, and careful, objective monitoring of drug efficacy should be performed. When pharmacologic treatment of ventricular arrhythmias is considered, treatment algorithms that incorporate LVEF measurements, Holter monitor recordings, and SAECG may aid the clinician.

Original languageEnglish (US)
Pages (from-to)195-205
Number of pages11
JournalClinical Pharmacy
Volume10
Issue number3
StatePublished - Jan 1 1991
Externally publishedYes

Fingerprint

Anti-Arrhythmia Agents
Cardiac Arrhythmias
Ambulatory Electrocardiography
Drug Therapy
Stroke Volume
Electrocardiography
Therapeutics
Symptom Assessment
Drug Monitoring
Tachycardia
Exercise
Survival
Serum

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

Evaluation and treatment of ventricular arrhythmias : An update. / McCollam, P. L.; Parker, Robert.

In: Clinical Pharmacy, Vol. 10, No. 3, 01.01.1991, p. 195-205.

Research output: Contribution to journalReview article

@article{a12cb2f6acca49f298e10746ae7d2a4e,
title = "Evaluation and treatment of ventricular arrhythmias: An update",
abstract = "An overall approach to evaluating and treating ventricular arrhythmias based on objective monitoring criteria is described. A clinically useful system classifies patients based on whether their ventricular arrhythmias are benign, potentially lethal, or lethal. Some clinicians believe that antiarrhythmic drug therapy improves survival in patients with potentially lethal arrhythmias. However, disappointing results from the Cardiac Arrhythmia Suppression Trial have led to a greater awareness of the potential adverse effects of antiarrhythmics. Various risk factors for arrhythmia-related death have been identified, such as the presence of frequent and complex ventricular ectopy, abnormal signal- averaged electrocardiography (SAECG) tracings, and poor left ventricular ejection fraction (LVEF). Antiarrhythmic drugs remain the primary mode of therapy for patients with recurrent symptomatic tachycardias. Antiarrhythmic drug efficacy has been evaluated by methods including symptom assessment, continuous ambulatory electrocardiographic monitoring (Holter monitoring), exercise testing, and invasive electrophysiologic testing. There may be an extremely wide range of effective serum concentrations for the class IA agents. Individual target concentrations of antiarrhythmic agents may be determined for individual patients and should assist the clinician in optimizing long-term antiarrhythmic drug therapy. The risk-to-benefit ratio of treatment should be weighed before antiarrhythmic drug therapy is begun, and careful, objective monitoring of drug efficacy should be performed. When pharmacologic treatment of ventricular arrhythmias is considered, treatment algorithms that incorporate LVEF measurements, Holter monitor recordings, and SAECG may aid the clinician.",
author = "McCollam, {P. L.} and Robert Parker",
year = "1991",
month = "1",
day = "1",
language = "English (US)",
volume = "10",
pages = "195--205",
journal = "Clinical Pharmacy",
issn = "0278-2677",
publisher = "American Society of Hospital Pharmacists",
number = "3",

}

TY - JOUR

T1 - Evaluation and treatment of ventricular arrhythmias

T2 - An update

AU - McCollam, P. L.

AU - Parker, Robert

PY - 1991/1/1

Y1 - 1991/1/1

N2 - An overall approach to evaluating and treating ventricular arrhythmias based on objective monitoring criteria is described. A clinically useful system classifies patients based on whether their ventricular arrhythmias are benign, potentially lethal, or lethal. Some clinicians believe that antiarrhythmic drug therapy improves survival in patients with potentially lethal arrhythmias. However, disappointing results from the Cardiac Arrhythmia Suppression Trial have led to a greater awareness of the potential adverse effects of antiarrhythmics. Various risk factors for arrhythmia-related death have been identified, such as the presence of frequent and complex ventricular ectopy, abnormal signal- averaged electrocardiography (SAECG) tracings, and poor left ventricular ejection fraction (LVEF). Antiarrhythmic drugs remain the primary mode of therapy for patients with recurrent symptomatic tachycardias. Antiarrhythmic drug efficacy has been evaluated by methods including symptom assessment, continuous ambulatory electrocardiographic monitoring (Holter monitoring), exercise testing, and invasive electrophysiologic testing. There may be an extremely wide range of effective serum concentrations for the class IA agents. Individual target concentrations of antiarrhythmic agents may be determined for individual patients and should assist the clinician in optimizing long-term antiarrhythmic drug therapy. The risk-to-benefit ratio of treatment should be weighed before antiarrhythmic drug therapy is begun, and careful, objective monitoring of drug efficacy should be performed. When pharmacologic treatment of ventricular arrhythmias is considered, treatment algorithms that incorporate LVEF measurements, Holter monitor recordings, and SAECG may aid the clinician.

AB - An overall approach to evaluating and treating ventricular arrhythmias based on objective monitoring criteria is described. A clinically useful system classifies patients based on whether their ventricular arrhythmias are benign, potentially lethal, or lethal. Some clinicians believe that antiarrhythmic drug therapy improves survival in patients with potentially lethal arrhythmias. However, disappointing results from the Cardiac Arrhythmia Suppression Trial have led to a greater awareness of the potential adverse effects of antiarrhythmics. Various risk factors for arrhythmia-related death have been identified, such as the presence of frequent and complex ventricular ectopy, abnormal signal- averaged electrocardiography (SAECG) tracings, and poor left ventricular ejection fraction (LVEF). Antiarrhythmic drugs remain the primary mode of therapy for patients with recurrent symptomatic tachycardias. Antiarrhythmic drug efficacy has been evaluated by methods including symptom assessment, continuous ambulatory electrocardiographic monitoring (Holter monitoring), exercise testing, and invasive electrophysiologic testing. There may be an extremely wide range of effective serum concentrations for the class IA agents. Individual target concentrations of antiarrhythmic agents may be determined for individual patients and should assist the clinician in optimizing long-term antiarrhythmic drug therapy. The risk-to-benefit ratio of treatment should be weighed before antiarrhythmic drug therapy is begun, and careful, objective monitoring of drug efficacy should be performed. When pharmacologic treatment of ventricular arrhythmias is considered, treatment algorithms that incorporate LVEF measurements, Holter monitor recordings, and SAECG may aid the clinician.

UR - http://www.scopus.com/inward/record.url?scp=0026096613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026096613&partnerID=8YFLogxK

M3 - Review article

VL - 10

SP - 195

EP - 205

JO - Clinical Pharmacy

JF - Clinical Pharmacy

SN - 0278-2677

IS - 3

ER -