Medical therapy to prevent recurrence of ventricular arrhythmia in normal and structural heart disease patients

ABSTRACT

Introduction: Recurrent ventricular arrhythmias (VA) are a source of significant morbidity in patients without structural heart disease (SHD) and also mortality in patients with SHD. The treatment goals for these two patient populations differ greatly.

Areas covered: The secondary prevention of recurrent VA in patients without and with SHD will be reviewed, focusing on clinical data (especially randomized, controlled trials) in the literature as determined through searches in PubMed and ClinicalTrials.gov. This will include β blockers, non-dihydropyridine calcium channel blockers and antiarrhythmic drugs in both subgroups and non-antiarrhythmic medications in SHD.

Expert commentary: The available options for medical therapy for VA in both normal hearts and SHD are insufficient, due to substandard efficacy and toxicities. While non-pharmacologic therapies may provide an excellent option, further drug development and randomized trials are needed, as is a reappraisal of the current mode of utilization.

KEYWORDS:

• Ventricular tachycardia
• ventricular fibrillation
• premature ventricular contractions
• idiopathic
• cardiomyopathy
• antiarrhythmic drugs

Declaration of interest

J Jacobson is a consultant for St Jude Medical and Biosense Webster. S Iwai is a consultant for Biosense Webster and Biotronik. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.