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Research Article| Volume 54, ISSUE 4, P2-7, August 13, 1984

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Perspectives on the current treatment of cardiac arrhythmias

  • J.Thomas Bigger Jr.
    Correspondence
    Address for reprints: J. Thomas Bigger, Jr., MD, Arrhythmia Control Unit, Columbia-Presbyterian Medical Center, 630 West 168th Street, New York, New York 10032.
    Affiliations
    From the Division of Cardiology, Department of Medicine, Columbia University, and the Arrhythmia Control Unit, Columbia-Presbyterian Medical Center, New York, New York USA
    Search for articles by this author
DOI:https://doi.org/10.1016/0002-9149(84)90817-8
Perspectives on the current treatment of cardiac arrhythmias
Previous ArticleNew directions in antiarrhythmic drug therapy: The development of a promising new agent, lorcainide
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      Abstract

      Our current understanding of human cardiac arrhythmias is primitive and their treatment is largely empirical. For a few arrhythmias for which the mechanism is known, this information is valuable in selecting therapy. Primary methods for arrhythmia detection are 24-hour electrocardiographic recordings, patient-activated recordings, exercise and cardiac electrophysiologic studies. A search for removable causes of arrhythmia should be sought before instituting specific treatment with antiarrhythmic drugs, surgery or implantable devices. Over the past 20 years, the spectrum of antiarrhythmic drug action has broadened; sodium channel blockers, β-adrenergic blockers and calcium channel blockers have extended our therapeutic options, but the ideal drug has yet to appear. Efficacy and convenience of antiarrhythmic drugs have improved significantly, but adverse effects and drug interactions still occur much too frequently. The outlook for patients with malignant arrhythmias has improved significantly. However, the 2 methods for evaluating therapy of malignant arrhythmias are time-consuming, uncomfortable and expensive. Basic and clinical research is rapidly advancing our knowledge and effectiveness in dealing with cardiac arrhythmias. As a result, we can expect substantial improvements in arrhythmia control in the future.
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      Article info

      Footnotes

      ☆This study was supported in part by Grants HL-22982, HL-12738 and HL-70204 from the National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland; by Grant RR-00645 from the Research Resources Administration, Bethesda, Maryland; by a Grant-in-Aid from the American Heart Association, Dallas, Texas; and by grants from the Winthrop and Chernow Foundations, New York, New York.

      Identification

      DOI: https://doi.org/10.1016/0002-9149(84)90817-8

      Copyright

      © 1984 Published by Elsevier Inc.

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