Bennett B, Singh S
Cardiology Division, VA Medical Center, Washington, DC 20422.
Am J Crit Care. 1992 Nov;1(3):107-14.
To review the changing environment of antiarrhythmic therapy.
The majority of articles chosen were written by experts in the field of arrhythmia management. The references include a pilot study, abstracts, original articles and results of study groups. An equal number of sources used in this article were obtained from fellow healthcare professionals and MEDLINE searches.
Large, controlled clinical trials in which patient populations had structural heart disease, prior myocardial infarction and/or frequent ventricular premature beats. All were treated with either antiarrhythmic therapy or devices.
Past research in the field of arrhythmia management has indicated that ventricular premature beat suppression is the key to increasing patient survival. After reviewing the results of such pivotal trials as the Cardiac Arrhythmia Suppression Trial, however, the question of whether to initiate therapy remains.
Several trials investigating the efficacy of antiarrhythmic drugs in decreasing sudden death have yielded disappointing results. These trials have been beneficial, however, in classifying arrhythmias and assessing patient risk. The outcomes of these trials, combined with advances in the treatment of heart disease, provide us with a framework for antiarrhythmic therapy. Additional controlled clinical trials are necessary if we are to learn the best means of increasing survival in ventricular arrhythmia patients.
回顾抗心律失常治疗不断变化的环境。
所选文章大多由心律失常管理领域的专家撰写。参考文献包括一项初步研究、摘要、原创文章和研究小组的结果。本文使用的同等数量的资料来源是从医疗同行和医学文献数据库检索中获得的。
针对患有结构性心脏病、既往心肌梗死和/或频发室性早搏的患者群体进行的大型对照临床试验。所有患者均接受抗心律失常治疗或使用器械治疗。
心律失常管理领域过去的研究表明，抑制室性早搏是提高患者生存率的关键。然而，在回顾了诸如心律失常抑制试验等关键试验的结果后，是否开始治疗的问题仍然存在。
几项调查抗心律失常药物降低猝死疗效的试验结果令人失望。然而，这些试验在心律失常分类和评估患者风险方面是有益的。这些试验的结果，结合心脏病治疗的进展，为我们提供了抗心律失常治疗的框架。如果我们要了解提高室性心律失常患者生存率的最佳方法，还需要进行更多的对照临床试验。
