THE MANAGEMENT OF VENTRICULAR ARRHYTHMIAS IN OLDER PATIENTS AFTER CAST

Asymptomatic nonsustained ventricular tachycardia and complex ventricu lar arrhythmias in elderly persons without heart disease should not be treated with antiarrhythmic drugs. Nonsustained ventricular tachycard ia and complex ventricular arrhythmias in elderly persons are associat ed with an increased incidence of coronary events, primary ventricular fibrillation and sudden cardiac death, especially if abnormal left ve ntricular ejection fraction, left ventricular hypertrophy or silent is chaemia are present. beta-Blockers should be used in the treatment of elderly patients with ventricular tachycardia or complex ventricular a rrhythmias associated with ischaemic or nonischaemic heart disease if there are no contraindications to beta-blocker therapy. I would reserv e the use of amiodarone in the treatment of ventricular tachycardia or complex ventricular arrhythmias to life-threatening ventricular tachy arrhythmias in elderly patients who cannot tolerate or who do not resp ond to beta-blockers.