[Ventricular cardiac arrhythmias 1992. Summary and perspectives].

The treatment of tachycardias has undergone marked changes. Doubts on the effectiveness and the benefits of antiarrhythmic drug therapy are the reason for a re-evaluation of the use of so-called class I- and class III-antiarrhythmic drugs. At the same time, there has been an increased awareness of new techniques for risk assessment; for instance, in postmyocardial infarction patients, not only the type and frequency of spontaneous arrhythmias but also other parameters like extent of left ventricular dysfunction, ventricular late potentials, inducible ventricular arrhythmias and effects of the autonomous nervous system should be considered. Serial electrophysiological testing to predict the efficacy of antiarrhythmic drug therapy has recently been challenged. Non-pharmacological approaches have been used in an increasing proportion of patients. Nevertheless, there is also an increasing interest in new antiarrhythmic drugs, especially those that prolong repolarization (class III).