ADVANCED CARDIAC LIFE-SUPPORT CONTROVERSY - WHERE DO ANTIARRHYTHMIC AGENTS FIT IN

Approximately half of all. cardiovascular fatalities are attributable to sudden cardiac death, and the majority of sudden cardiac deaths res ult from ventricular fibrillation (VF). Antiarrhythmic agents are need ed to manage refractory VF and ventricular tachycardia (VT); the prima ry reason for their administration is to prevent recurrence of VF and to abolish VT. The American Heart Association recommends lidocaine hyd rochloride as a first-line antiarrhythmic agent in the advanced cardia c life support (ACLS) setting, followed by bretylium tosylate. Althoug h the newly approved intravenous antiarrhythmic agent, amiodarone hydr ochloride, may potentially be effective in ACLS, studies are needed to document its clinical benefit in this setting. Such studies are curre ntly under way to document this potential use.