DRUG AND DEFIBRILLATOR INTERACTIONS

We reviewed the interactions of drugs and defibrillators, with emphasi s on implantable cardioverter defibrillators. Articles were identified by searching MEDLINE from 1966 to the present; additional sources wer e identified from reference lists in these articles. Drugs have the po tential for both beneficial and harmful interactions with electrical t herapy. Beneficial interactions include reductions in the energy requi red to defibrillate the heart and in the occurrence of arrhythmia resu lting in decreased shock frequency, prolonged device longevity, and im proved patient comfort. Potentially harmful interactions include alter ing the detection of ventricular tachycardia; altering the pacing thre shold, resulting in interference with bradycardia or antitachycardia p acing; development of incessant ventricular tachycardia; and increasin g the energy required to defibrillate the heart. As the use of implant able cardioverter defibrillators increases, pharmacists should be awar e of the potential for drug-device interactions.