Haverkamp W, Borggrefe M, Block M, Böcker D, Breithardt G
Med. Klinik und Poliklinik Innere Medizin C Westfälische Wilhelms-Universität, Münster.
Z Kardiol. 1996;85 Suppl 6:97-106.
Treatment strategies in patients with life-threatening ventricular tachyarrhythmias (i.e. sustained ventricular tachycardia, ventricular fibrillation, aborted sudden cardiac death) are changing. Amiodarone and d,l-sotalol, chosen by electrophysiologic study guidance, can be considered as drugs of choice for the pharmacological treatment. Compared to these agents, which both have additional electrophysiologic effects, the new pure class III agents seem to be less effective. With regard to antiarrhythmic efficacy, clinical trials comparing the long-term efficacy of antiarrhythmic agents and the implantable cardioverter/defibrillator are under way. Preliminary results indicate that the implantable cardioverter/defibrillator may provide superior outcome with regard to sudden cardiac death compared to the use of class III agents.
危及生命的室性快速心律失常(即持续性室性心动过速、心室颤动、心脏骤停复苏)患者的治疗策略正在发生变化。在电生理研究指导下选用的胺碘酮和d,l-索他洛尔可被视为药物治疗的首选药物。与这两种均具有额外电生理效应的药物相比,新型单纯III类药物似乎效果较差。关于抗心律失常疗效,比较抗心律失常药物与植入式心脏复律除颤器长期疗效的临床试验正在进行。初步结果表明,与使用III类药物相比,植入式心脏复律除颤器在心脏性猝死方面可能具有更好的疗效。