Antitachycardia Strategies

The development of an antitachycardia strategy requires a cascade of assessments and decisions. The patient's problem and level of risk must be assessed in order to determine the goals of therapy. Empirical therapy is appropriate in low‐risk situations, and during that ultimate emergency, the treatment of cardiac arrest. Quantitative objective assessment of therapeutic efficacy is indicated in most other situations. Such assessments may be primarily passive, such as recording of drug blood levels or serial Holter monitoring; of provocative, as in serial electrophysiologic, exercise, or psychological stress testing. Selection of an antiarrhythmic modality requires a balance between the risk of therapy and the risks related to the arrhythmia. Any antitachycardia strategy must also consider relative costs, and regulatory and reimbursement policies.