Parenteral Antiarrhythmics for Life-Threatening Ventricular Arrhythmias |
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Authors: | ROLAND A. FILART M.D. SETH J. RIALS M.D. Ph .D. ROGER A. MARINCHAK M.D. PETER R. KOWEY M.D. |
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Affiliation: | Division of Cardiovascular Diseases, The Lankenau Hospital and Medical Research Center, Wynnewood, Pennsylvania and the Department of Medicine, Jefferson Medical College of the Thomas Jefferson University, Philadelphia, Pennsylvania |
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Abstract: | Parenteral Antiarrhythmics for Ventricular Arrhythmias. The acute management of life-threatening ventricular tachyarrhythmias often includes the use of parenteral antiarrhythmics. There are a number of agents currently available for this purpose. They are used to suppress inducible monomorphic ventricular tachycardia during programmed electrical stimulation, they terminate spontaneous sustained ventricular tachycardia, and prevent ventricular fibrillation in the setting of an acute myocardial infarction. Serious adverse reactions include proarrhythmia, hypotension, severe bradyarrhythmias, and precipitation of congestive heart failure. A comparative evaluation of intravenous antiarrhythmics is difficult due to inherent differences in the choice of agents for study, protocol design, patient population, defined endpoints, and serum drug levels. Likewise, the reported adverse reaction rates vary from 0.4% to 75%. To understand the difficulties in clinical decision-making in this problem area, particularly drug selection, we present here a review of pertinent clinical trials evaluating parenteral drug efficacy and adverse effects. |
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Keywords: | parenteral antiarrhythmics parenteral beta blockers ventricular tachycardia ventricular fibrillation myocardial infarction coronary artery disease |
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