ANTIARRHYTHMIC DRUG-THERAPY FOR VENTRICULAR ARRHYTHMIA - CURRENT PERSPECTIVES

Pharmacologic therapy for ventricular arrhythmias has undergone a rema rkable change recently, Recognition of the importance of underlying st ructural heart disease on prognostic implications of ventricular arrhy thmias has resulted in the refinement of the clinical classification o f these arrhythmias, With refinement of techniques of risk stratificat ion, it is now possible to identify patients with ventricular arrhythm ias at high risk for sudden death, Retrospective analyses of prior ant iarrhythmic drug trials and new data from prospective randomized trial s are now available and can more directly define the risks and benefit s of antiarrhythmic therapy, Prevention of sudden death, reduction in total mortality, or improvement in symptoms remain the only benefits o f antiarrhythmic drugs, With inclusion of total mortality as the major endpoint for assessment of pharmacologic interventions in high-risk p atients, the potential for excess mortality due to antiarrhythmic agen ts is now recognized, The pharmacologic diversity of newly released an tiarrhythmic agents and others under development has resulted in a re- evaluation of the traditional classification of these drugs, Multiple ongoing clinical trials will define the risks and benefits of antiarrh ythmic therapy and other nonpharmacologic interventions in patients wi th ventricular arrhythmias.