Intravenous antiarrhythmic therapy for high-risk patients

Patients suffering any form of heart disease are at risk of developing mali gnant ventricular arrhythmia and sudden cardiac death. It is, however, now possible to prevent recurrence and sudden death over the long term but seco ndary prevention assumes recovery from a primary event and the suppression of acute arrhythmias that may occur after the initial resuscitation. Data s upporting the efficacy and safety of conventional antiarrhythmic drugs for these indications are weak. However, there has been renewed interest in thi s subject. Several new parenteral antiarrhythmic drugs have entered and/or completed clinical development. Many of these drugs have been found to have an effect on ventricular electrical properties and are possibly of use in acute termination and suppression of life-threatening arrhythmias. In parti cular, intravenous amiodarone has proved effective in treating frequently r ecurrent ventricular tachycardia/fibrillation and is currently being studie d specifically in the cardiac arrest patient. II is anticipated that these agents will increase the chances of long-term survival, whilst retaining ne urological function, in patients with otherwise lethal arrhythmias. This pa per reviews the parenteral antiarrhythmic agents currently available for cl inical use and how they may be incorporated into the care of these patients .