Lege Artis Medicinae

[The treatment of life-threathening ventricular tachyarrhythmias in coronary artery disease - Antiarrhythmic drug or implantable cardioverter-defibrillator?]

BORBOLA József1

SEPTEMBER 01, 2000

Lege Artis Medicinae - 2000;10(09)

[Sudden cardiac death due to sustained ventricular tachyarrhythmias accounts for approximately 50% of all cardiovascular deaths. From the major therapeutic options currently available, antiarrhythmic drug therapy and implantation of automatic car dioverter-defibrillators could be applied to the great majority of patients. Both early observations on automatic implantable cardioverter-defibrillator devices and more recent prospective, randomized, multicenter trials with long-term outcome data uniformly document sudden cardiac death recurrence rates of 1% to 2% annually, compared with recurrences rates of 15% to 25% without the device. There is now compelling evidence from studies suggesing that these devices are superior to antiarrhythmic drugs (Class I and III), both in terms of effectivity and life-saving effects. The implantation of the automatic cardioverter-defibrillator device is currently the first choice therapy for cardiac arrest survivors based on the AHA/ACC guideline (1998), and has to be considered in each case. In the future, the common, hybride treatment with antiarrhythmic device and drugs is expected. ]

AFFILIATIONS

  1. Gottsegen György Országos Kardiológiai Intézet, Budapest

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