Aronow W S
Hebrew Hospital Home, Bronx, NY 10475, USA.
J Am Geriatr Soc. 1995 Jun;43(6):688-95. doi: 10.1111/j.1532-5415.1995.tb07208.x.
To review the prognosis and management of ventricular arrhythmias (VA) in persons with and without heart disease with emphasis on older adults.
A computer-assisted search of the English language literature (MEDLINE database) followed by a manual search of the bibliographies of pertinent articles.
Studies on the prognosis and management of VA in persons with and without heart disease were screened for review. Studies in older people and recent studies were emphasized.
Pertinent data were extracted from the reviewed articles. Emphasis was on studies involving the older persons. Relevant articles were reviewed in depth.
Available data about the prognosis and management of VA in persons with and without heart disease, with emphasis on studies involving older people, were summarized.
VA in older persons without heart disease should not be treated with antiarrhythmic drugs. Class I antiarrhythmic drugs should not be used to treat VA in older persons with heart disease. Beta blockers should be used to treat complex VA in older persons with ischemic or nonischemic heart disease if there are no contraindications to beta blocker therapy. The use of amiodarone in treating complex VA should be reserved for life-threatening ventricular tachyarrhythmias in older persons who cannot tolerate or who do not respond to beta blockers. VA associated with congestive heart failure should be treated with angiotensin converting enzyme inhibitors. If older patients have life-threatening recurrent ventricular tachycardia or ventricular fibrillation resistant to antiarrhythmic drugs, invasive intervention should be performed. The automatic implantable cardioverter-defibrillator is recommended in older patients who have medically refractory sustained ventricular tachycardia or ventricular fibrillation.
回顾有无心脏病患者室性心律失常（VA）的预后及处理，重点关注老年人。
对英文文献（MEDLINE数据库）进行计算机辅助检索，随后手动检索相关文章的参考文献。
筛选有关有无心脏病患者VA预后及处理的研究进行综述。重点关注老年人相关研究及近期研究。
从综述文章中提取相关数据。重点是涉及老年人的研究。对相关文章进行深入综述。
总结有无心脏病患者VA预后及处理的现有数据，重点是涉及老年人的研究。
无心脏病的老年人发生VA不应使用抗心律失常药物治疗。I类抗心律失常药物不应用于治疗有心脏病的老年人的VA。如果没有β受体阻滞剂治疗的禁忌证，β受体阻滞剂应用于治疗有缺血性或非缺血性心脏病的老年人的复杂性VA。胺碘酮用于治疗复杂性VA应仅限于不能耐受或对β受体阻滞剂无反应的有危及生命的室性快速性心律失常的老年人。与充血性心力衰竭相关的VA应使用血管紧张素转换酶抑制剂治疗。如果老年患者有危及生命的复发性室性心动过速或对抗心律失常药物耐药的心室颤动，应进行侵入性干预。对于药物治疗难治的持续性室性心动过速或心室颤动的老年患者，推荐使用自动植入式心脏复律除颤器。
