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Ventricular Tachycardia/Fibrillation: Therapeutic Alternatives
Author(s) -
FISHER JOHN D.,
KIM SOO G.,
ROTH JAMES A.,
FERRICK KEVIN J.,
BRODMAN RICHARD F.,
GROSS JAY N.,
FURMAN SEYMOUR
Publication year - 1991
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1991.tb05124.x
Subject(s) - medicine , ventricular fibrillation , cardiology , ventricular tachycardia , implantable cardioverter defibrillator , fibrillation , catheter ablation , ablation , sudden cardiac death , tachycardia , atrial fibrillation , electrophysiology study
It is now clear that no single therapy is appropriate for a consecutive series of patients with ventricular tachycardia or ventricular fibrillation (VT/VF). Drug responders by electrophysiological studies, patients who are not inducible following surgery, and patients treated with an implantable cardioverter defibrillator (ICD) all can have similarly low sudden death rates and virtually identical long‐term mortality. However, many patients fail to respond to drugs, and surgical risks are excessive in others, and always higher than for an ICD implant. Nevertheless, overall survival in each of these groups (and probably for patients treated with antitachycardia pacers and ablation) is about 60% at 60 months. Major challenges now are: (1) choosing therapy to maximize risk‐benefit ratio; and (2) treatment of the pump failure and progressive disease that now accounts for most cardiac mortality.