Aronow W S
Cardiology Division, Department of Medicine, New York Medical College, Valhalla, New York, NY 10595, USA.
Minerva Cardioangiol. 2010 Dec;58(6):657-76.
Underlying causes of ventricular tachycardia (VT) or complex ventricular arrhythmias (VA) should be treated if possible. Anti-arrhythmic drugs should not be used to treat asymptomatic patients with complex VA and no heart disease. Beta blockers are the only antiarrhythmic drugs that have been documented to reduce mortality in patients with VT or complex VA. Radiofrequency catheter ablation of VT has been beneficial in treating selected patients with arrhythmogenic foci of monomorphic VT. The automatic implantable cardioverter-defibrillator (AICD) is the most effective treatment for patients with life-threatening VT or ventricular fibrillation. The American College of Cardiology/American Heart Association class I indications for an AICD are discussed. Other indications for an AICD are discussed. Patients with AICDs should be treated with biventricular pacing, not with dual-chamber rate-responsive pacing at a rate of 70/minute. Patients with AICDs should be treated with beta blockers, statins, and angiotensin-converting enzyme inhibitors or angiotensin blockers.
如果可能，应治疗室性心动过速（VT）或复杂性室性心律失常（VA）的潜在病因。抗心律失常药物不应用于治疗无心脏病的无症状复杂性VA患者。β受体阻滞剂是唯一已被证明可降低VT或复杂性VA患者死亡率的抗心律失常药物。VT的射频导管消融术对治疗某些具有单形性VT致心律失常病灶的患者有益。自动植入式心脏复律除颤器（AICD）是治疗危及生命的VT或心室颤动患者最有效的方法。讨论了美国心脏病学会/美国心脏协会关于AICD的I类适应症。还讨论了AICD的其他适应症。植入AICD的患者应接受双心室起搏治疗，而不是以每分钟70次的频率进行双腔频率应答起搏。植入AICD的患者应接受β受体阻滞剂、他汀类药物和血管紧张素转换酶抑制剂或血管紧张素阻滞剂治疗。
