Treatment of chronic ventricular arrhythmias

Treatment of chronic ventricular arrhythmias at present is difficult, involving the use of antiarrhythmic medication with frequent serious side effects and limited efficacy. Moreover, indications for initiating treatment are not clear-cut as data continue to accumulate about the prognostic significance of ventricular arrhythmias in various clinical settings. In light of this, treatment goals must be set individually. Antiarrhythmic agents must be utilized optimally, with due consideration to pharmacokinetics. In all cases, proper therapeutic planning requires adequate data, documentation of the severity of the ectopia, and, equally important, documentation of the efficacy of therapeutic efforts. In this review, the authors will develop guidelines for a rational approach to the management of the patient with ventricular arrhythmias.