NONSUSTAINED VENTRICULAR-TACHYCARDIA IN ISCHEMIC-HEART-DISEASE - WHENAND WHICH PHARMACOLOGICAL TREATMENT

Nonsustained ventricular tachycardia is not uncommon both in the prese nce and absence of organic heart disease and in the latter situation, is usually not associated with an increased risk, However, in patients with ischemic heart disease, especially in the post-infarction period , nonsustained ventricular tachycardia is associated with an increased risk of sudden, and possibly non-sudden, cardiac death. Several non-i nvasive and invasive tests have been utilized, individually or in comb ination, to risk stratify those patients. Left ventricular ejection fr action, the signal averaged electrocardiogram, and especially programm ed ventricular stimulation have been commonly utilized to identify tho se patients at high risk for malignant tachyarrhythmias and to evaluat e the potential benefit from antiarrhythmic treatment, At present, how ever, there is no consensus as to the best strategy to identify and tr eat high risk patients, Several ongoing multicenter clinical trials ma y eventually provide such guidelines, In the meantime, an algorithm fo r the management of those patients is suggested.