EVALUATION AND TREATMENT OF NONSUSTAINED VENTRICULAR-TACHYCARDIA

The clinical significance of nonsustained ventricular tachycardia cont inues to undergo reevaluation as clinicians attempt to optimize screen ing strategies for identifying high-risk patients and to evaluate the efficacy of therapeutic interventions. The utility of ambulatory monit oring and programmed stimulation as screening tools in the patient who has suffered an infarction remains unsettled; ongoing clinical trials may help resolve these issues. New data suggest that the survival ben efit associated with angiotensin-converting enzyme inhibition is unrel ated to effects on spontaneous arrhythmias, similar to results previou sly reported for beta-blockers; Randomized clinical trials of prophyla ctic amiodarone in patients with congestive heart failure and nonsusta ined ventricular tachycardia have produced conflicting results. A stro ng relationship between polymorphic nonsustained ventricular tachycard ia and sudden death in patients without structural heart disease or QT prolongation has been reported. The significance of nonsustained vent ricular tachycardia in dilated cardiomyopathy and hypertrophic cardiom yopathy has also been reassessed.