ABSTRACT

Introduction Major advances in our understanding and management of cardiac arrhythmias have taken place over the last decade. Radiofrequency catheter ablation has dramatically altered the management of non-life threatening tachycardias and implantable defibrillators have become first-line therapy in the management of cardiac arrest survivors. In high-risk patients who have not previously experienced a life-threatening ventricular tachyarrhythmia, primary prevention of sudden death has been the focus of major prospective multicenter clinical trials. The role of device therapy and prophylactic drug therapy in these patients has yet to be fully elucidated (Table 19.1).1-9

Several strategies, both competing and complementary, are frequently available to the clinician. This chapter will give a brief overview of the management of cardiac arrhythmias and focus on the present role of drug therapy, both as monotherapy and in combination with non-pharmacologic options.