While implantable cardioverter defibrillators decrease mortality in high risk groups
of patients who have ventricular arrhythmias, antiarrhythmic drugs are still required
to reduce the burden of both benign and life-threatening arrhythmias. This review
will address the available medical therapy for ventricular arrhythmias in Australia
and their use in different clinical situations.
Abbreviations:
AAD (antiarrhythmic drug), ARVC (arrhythmogenic right ventricular cardiomyopathy), CPVT (catecholaminergic polymorphic ventricular tachycardia), DCCV (direct current cardioversion), ERS (early repolarisation syndrome), HCM (hypertrophic cardiomyopathy), ICD (implantable cardioverter defibrill ator), IV (intravenous [Also Class IV agent]), LV (left ventricular), NSVT (non- sustained ventricular tachycardia), PVC (premature ventricular contractions), RCT (randomised controlled trial), SCD (sudden cardiac death), TDP (Torsades de pointes), TGA (Therapeutic Drugs Administration), VF (ventricular fibrillation), VT (ventricular tachycardia)Keywords
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References
- Should catheter ablation be the preferred therapy for reducing ICD shocks?: Ventricular tachycardia ablation versus drugs for preventing ICD shocks: role of adjuvant antiarrhythmic drug therapy.Circ Arrhythm Electrophysiol. 2009; 2 (discussion 12): 705-711
- Adjunctive drug therapy of acute myocardial infarction—evidence from clinical trials.N Engl J Med. 1996; 335: 1660-1667
- A meta-analysis of the effects of β-adrenergic blockers in chronic heart failure.Exp Ther Med. 2016; 12: 2489-2496
- Nadolol decreases the incidence and severity of ventricular arrhythmias during exercise stress testing compared with beta1-selective beta-blockers in patients with catecholaminergic polymorphic ventricular tachycardia.Heart Rhythm. 2016; 13: 433-440
- Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial.N Engl J Med. 1991; 324: 781-788
- Mexiletine prevents recurrent torsades de pointes in acquired long QT syndrome refractory to conventional measures.JACC Clin Electrophysiol. 2015; 1: 315-322
- Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials.Circulation. 1990; 82: 1106-1116
- Management of brugada syndrome: thirty-three-year experience using electrophysiologically guided therapy with class 1a antiarrhythmic drugs.Circ Arrhythm Electrophysiol. 2015; 8: 1393-1402
- J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge.Europace. 2017; 19: 665-694
- AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.Heart Rhythm. 2017;
- Predictors and therapy of cardiomyopathy caused by frequent ventricular ectopy.Curr Cardiol Rep. 2017; 19: 80
- Class IC antiarrhythmic drugs for suspected premature ventricular contraction-induced cardiomyopathy.Heart Rhythm. 2018; 15: 159-163
- Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study.Circ Arrhythm Electrophysiol. 2014; 7: 237-243
- Magnesium: an antiarrhythmic drug, but only against very specific arrhythmias.Eur Heart J. 2000; 21: 1116
- Drug therapy in cardiac arrest: a review of the literature.Eur Heart J Cardiovasc Pharmacother. 2016; 2: 54-75
- Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation.N Engl J Med. 1999; 341: 871-878
- Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest.N Engl J Med. 2016; 374: 1711-1722
- Part 7: adult advanced cardiovascular life support: 2015 American heart association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.Circulation. 2015; 132: S444-S464
- The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial.Lancet (London, England). 1999; 353: 9-13
- Indications for internal cardioverter defibrillator implantation predict time to first shock and the modulating effect of beta-blockers.Am Heart J. 2005; 150: 1064
- ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 appropriate use criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy: a report of the American College of Cardiology Foundation appropriate use criteria task force, Heart Rhythm Society, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance.J Am Coll Cardiol. 2013; 61: 1318-1368
- Antidysrhythmic drug therapy for the termination of stable, monomorphic ventricular tachycardia: a systematic review.Emerg Med J. 2015; 32: 161-167
- Double-blind trial of lignocaine versus sotalol for acute termination of spontaneous sustained ventricular tachycardia.Lancet (London England). 1994; 344: 18-23
- Randomized double-blind trial of sotalol versus lignocaine in out-of-hospital refractory cardiac arrest due to ventricular tachyarrhythmia.Intern Med J. 2005; 35: 518-525
- Adjunctive antiarrhythmic drug therapy in patients with implantable cardioverter defibrillators: a systematic review.Eur Heart J. 2007; 28: 469-477
- Comparison of beta-blockers, amiodarone plus beta-blockers, or sotalol for prevention of shocks from implantable cardioverter defibrillators: the OPTIC Study: a randomized trial.JAMA. 2006; 295: 165-171
- EHRA/HRS/APHRS expert consensus on ventricular arrhythmias.Europace. 2014; 16: 1257-1283
- 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines.Circulation. 2011; 123: e269-e367
- Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: the Cardiac Arrest Study Hamburg (CASH).Circulation. 2000; 102: 748-754
- Ventricular tachycardia with ICD shocks: when to medicate and when to ablate.Curr Cardiol Rep. 2017; 19: 105
- Electrophysiologic mechanisms of antiarrhythmic efficacy of a sotalol and class Ia drug combination: elimination of reverse use dependence.J Am Coll Cardiol. 1997; 29: 100-105
- Role of antiarrhythmic drugs in patients with implantable cardioverter defibrillators.Europace. 2010; 12: 618-625
- Electrical storm: definitions, clinical importance, and treatment.Curr Opin Cardiol. 2013; 28: 72-79
- Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs.N Engl J Med. 2016; 375: 111-121
- Management of ventricular tachycardia storm in patients with structural heart disease.World J Cardiol. 2017; 9: 521-530
- Treatment of arrhythmogenic right ventricular cardiomyopathy/dysplasia: an international task force consensus statement.Circulation. 2015; 132: 441-453
- Efficacy of antiarrhythmic drugs in patients with arrhythmogenic right ventricular disease. Results in patients with inducible and noninducible ventricular tachycardia.Circulation. 1992; 86: 29-37
- Use of flecainide in combination antiarrhythmic therapy in patients with arrhythmogenic right ventricular cardiomyopathy.Heart Rhythm. 2017; 14: 564-569
- Efficacy of antiarrhythmic drugs in arrhythmogenic right ventricular cardiomyopathy: a report from the North American ARVC Registry.J Am Coll Cardiol. 2009; 54: 609-615
- Spectrum and prognostic significance of arrhythmias on ambulatory Holter electrocardiogram in hypertrophic cardiomyopathy.J Am Coll Cardiol. 2005; 45: 697-704
- Prognostic significance of 24 hour ambulatory electrocardiographic monitoring in patients with hypertrophic cardiomyopathy: a prospective study.Am J Cardiol. 1981; 48: 252-257
- Non-sustained ventricular tachycardia in hypertrophic cardiomyopathy: an independent marker of sudden death risk in young patients.J Am Coll Cardiol. 2003; 42: 873-879
- A validation study of the 2003 American College of Cardiology/European Society of Cardiology and 2011 American College of Cardiology Foundation/American Heart Association risk stratification and treatment algorithms for sudden cardiac death in patients with hypertrophic cardiomyopathy.Heart (British Cardiac Society). 2013; 99: 534-541
- Contemporary strategies for risk stratification and prevention of sudden death with the implantable defibrillator in hypertrophic cardiomyopathy.Heart Rhythm. 2016; 13: 1155-1165
- 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC).Eur Heart J. 2014; 35: 2733-2779
- Genotype-phenotype correlation in the long-QT syndrome: gene-specific triggers for life-threatening arrhythmias.Circulation. 2001; 103: 89-95
- Effectiveness and limitations of beta-blocker therapy in congenital long-QT syndrome.Circulation. 2000; 101: 616-623
- Association of long QT syndrome loci and cardiac events among patients treated with beta-blockers.JAMA. 2004; 292: 1341-1344
- Not all beta-blockers are equal in the management of long QT syndrome types 1 and 2: higher recurrence of events under metoprolol.J Am Coll Cardiol. 2012; 60: 2092-2099
- Left cardiac sympathetic denervation in the management of high-risk patients affected by the long-QT syndrome.Circulation. 2004; 109: 1826-1833
- Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes.Heart Rhythm. 2013; 10: e85-e108
- Clinical challenges in catecholaminergic polymorphic ventricular tachycardia.Heart Lung Circ. 2016; 25: 777-783
- Calcium channel antagonism reduces exercise-induced ventricular arrhythmias in catecholaminergic polymorphic ventricular tachycardia patients with RyR2 mutations.J Cardiovasc Electrophysiol. 2005; 16: 162-166
- Calcium channel blockers and beta-blockers versus beta-blockers alone for preventing exercise-induced arrhythmias in catecholaminergic polymorphic ventricular tachycardia.Heart Rhythm. 2007; 4: 1149-1154
- Flecainide prevents catecholaminergic polymorphic ventricular tachycardia in mice and humans.Nat Med. 2009; 15: 380-383
- Flecainide monotherapy is an option for selected patients with catecholaminergic polymorphic ventricular tachycardia intolerant of beta-blockade.Heart Rhythm. 2016; 13: 609-613
- Flecainide suppresses defibrillator-induced storming in catecholaminergic polymorphic ventricular tachycardia.Pacing Clin Electrophysiol. 2012; 35: 794-797
- Clinical management of catecholaminergic polymorphic ventricular tachycardia: the role of left cardiac sympathetic denervation.Circulation. 2015; 131: 2185-2193
- Electrical storms in Brugada syndrome successfully treated with isoproterenol infusion and quinidine orally.Neth Heart J. 2007; 15: 151-155
Article info
Publication history
Published online: October 13, 2018
Identification
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© 2018 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).