Ambulatory electrocardiography and the diagnosis, evaluation, and treatment of chronic ventricular arrhythmias

Winkle, Roger A.

doi:10.1016/0033-0620(80)90007-9

Cited by 77 publications

(6 citation statements)

References 108 publications

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“…arrhythmia prevalence in nonischemic disease, and to studies assessing specific drug interventions using ambulatory electrocardio graphic recording. Alternative perspectives arc available in other recent reviews and texts [11][12][13][14][15][16],…”

Section: Introductionmentioning

confidence: 99%

Clinical Applications of Ambulatory Electrocardiography

Kligfield

1984

Cardiology

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Section: Introductionmentioning

confidence: 99%

Clinical Applications of Ambulatory Electrocardiography

Kligfield

1984

Cardiology

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“…This may be the basis for a greater probability for sustained VT in patients with myocardial infarction who have poor left ventricular function. [12] Other clinical factors which portend an increased risk include presence of late potentials on signal-averaged ECG, [13] T wave alternans, [14,15] decreased heart rate variability, [16] high grade ventricular ectopy and non-sustained VT. [17] VT can also be encountered as a manifestation of acute myocardial ischemia. The pathogenesis here differs from that in reentrant VT seen in chronic ischemic heart disease.…”

Section: Ventricular Tachycardia (Vt) In Coronary Artery Diseasementioning

confidence: 99%

Etiology and Management of Sustained Ventricular Tachycardia

Naik

2001

American Journal of Cardiovascular Drugs

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Ventricular tachyarrhythmias secondary to a variety of underlying cardiovascular problems pose a therapeutic challenge to the clinician. The initial presentation may be as sudden cardiac death, which underlies its public health problem. The underlying conditions predisposing to this arrhythmia include ischemic heart disease, dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmiogenic right ventricle dysplasia and certain postoperative states including corrective surgery for tetralogy of Fallot and valve replacement. Other causes include prolonged QT syndrome, idiopathic right and left ventricle tachycardia and bundle branch re-entry tachycardia. Ischaemic heart disease is the most common cause of ventricular tachycardia and therapy has evolved considerably over the past two decades. The development of and refinements in the implantable cardioverter-defibrillator (ICD) have introduced a new dimension in therapeutic options and markedly improved survival in these patients. Insights in the dichotomy between arrhythmia suppression and total mortality have reoriented drug therapy with a decrease in the use of sodium channel blockers. beta-blockers have emerged as antiarrhythmic drugs in their own right and their synergistic effects with amiodarone have strengthened the antiarrhythmic drug arm. The role of these drugs in patients with hemodynamically stable ventricular tachycardia, especially in relatively preserved ventricles needs to be explored. Catheter ablation techniques have provided curative therapy in patients with idiopathic and bundle branch reentry tachycardia. Further advances in radiofrequency ablation, including use of newer mapping techniques, promise a greater role for ablation of ischemic ventricular tachycardia in the future. A hybrid approach consisting of drugs, catheter ablation and/ or ICD may provide effective therapeutic approach in some situations. Further innovations and technologic developments promise a further reorientation in therapy towards identification and treatment of the underlying arrhythmogenic substrate.

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“…Considerable attention has been focused on the electrophysiologic and pharmacotherapeutic aspects of ventricular anthythmias (Kastor et al, 1981;Lown, 1979;Vlay and Reid, 1982;Winkle, 1980). Much of the prior work involving psychologic variables associated with sudden cardiac death ceneted on precipitating factors (Greene et af., 1972.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial aspects of surviving sudden cardiac death

Vlay

Fricchione

1985

Clinical Cardiology

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Summary:The psychosocial problems faced by the survivor of "sudden cardiac death" are discussed from the point of view of the patient, the family, and the physician. The patient faces a battery of intensive diagnostic tests, as well as concern for future capability to resume function as "spouse, parent, and citizen." Emotions such as depression, anger, anxiety, frustration, and fear must be dealt with in a constructive manner. Management includes education, support, encouragement of adaptive denial, anxiolytic medication if necessary, and relaxation techniques when helpful. Our approach begins with education of the patient and family in regard to the medical aspects of the illness. Next, we provide support for the patient and allow the patient to express his or her concerns at an individual pace. Adaptive denial is encouraged and maladaptive denial addressed. Appropriate medication is prescribed when necessary, and finally, relaxation techniques may have a role in some patients. A strong physician-patient relationship is necessary for successful evaluation and therapy. The unique stresses of the cardiologist and the electrophysiology team are described.

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Ambulatory electrocardiography and the diagnosis, evaluation, and treatment of chronic ventricular arrhythmias

Cited by 77 publications

References 108 publications

Clinical Applications of Ambulatory Electrocardiography

Clinical Applications of Ambulatory Electrocardiography

Etiology and Management of Sustained Ventricular Tachycardia

Psychosocial aspects of surviving sudden cardiac death

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