By G. Turitto (auth.), Antonio Raviele MD (eds.)
The topic of cardiac arrhythmias is of sensible relevance. a number of arrhythmias are present in diverse scientific occasions, resembling untimely complexes in fit contributors, supraventricular tachyarrhythmias in sufferers with Wolff-Parkinson-White snydrome, atrioventricular block, and ventricular traumatic inflammation in cardiopathic stipulations, specially in sufferers with ischemic disorder. themes of significant curiosity are mentioned during this quantity: malignant ventricular arrhythmias, unexpected loss of life, computerized implantable cardioverter defibrillators, syncope, present symptoms for pacing remedy, radiofrequency catheter ablation, flutter, and atrial fibrillation.
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Extra resources for Cardiac Arrhythmias 1995: Proceedings of the 4th International Workshop on Cardiac Arrhythmias (Venice, 6–8 October 1995)
Di Carlo LA, Morady F, Sauve MJ et al (1985) Cardiac arrest and sudden death in patients treated with amiodarone for sustained ventricular tachycardia or ventricular fibrillation: risk stratification based on clinical variables. Am J Cardiol 55: 372374 48. Horowitz LN, Greenspan AM, Spielman SR et al (1985) Usefulness of electrophysiologic testing in evaluation of amiodarone therapy for sustained ventricular tachyarrhythmias associated with coronary heart disease. Am J Cardiol55: 367-371 49. Manolis AS, Uricchio F, Estes M (1989) Prognostic value of early electrophysiologic studies for ventricular tachycardia recurrence in patients with coronary artery disease treated with amiodarone.
Clinical results of empirical amiodarone treatment: cardiac (CM) and total mortality (TM) rates ('Yo) Reference Patients (n) 1-year CM TM 3-year CM TM 5-year CM TM (60) (61) (62) (54) 427 469 128 52 0 0 26 28 31 0 37 37 31 11 18 11 24 13 21 0 43 33 34 0 62 46 42 0 sustained VT or VF (62). The average age was 62 years, and the mean ejection fraction 36%. A total of 81 % of patients had coronary artery disease. After 1, 3 and 5 years, the sudden death rate was 9%, 16% and 20%, the total cardiac death rate was 18%, 28% and 37%, and the nonfatal VT recurrence rate was 5%, 15%, and 25% respectively.
All such agents blocked sodium-channel activity to varying degrees and had somewhat different offset and onset kinetics of sodium-channel block. In general these are powerful suppressants of PVCs but given the context of serious cardiac disease, they all may increase mortality, presumably by inducing serious life-threatening ventricular arrhythmias (3, 6, 7). They may increase sudden. death and may produce incessant VT/VF which may be difficult to cardiovert or defibrillate. As a class these agents have not been shown to reduce mortality in any subset of patients with cardiac disease.