Drug therapy for sustained ventricular arrhythmias complicating acute myocardial infarction: What does the crystal ball tell you?

摘要

Acute heart failure, mechanical complications including ventricular rupture, and sustained ventricular arrhythmias are the most common potentially life-threatening adverse events in patients with acute myo-cardial infarction (AMI) who survive to hos-pitalization (1,2; Fig. 1). Data from systematic studies to guide acute antiarrhythmic drug therapy for sustained ventricular arrhythmias including ventricular tachycardia (VT) and ventricular fibrillation (VF) in the setting of an AMI are sparse (3-5). Existing evidence could suggest that prophylactic lidocaine might be associated with an excess of mortality and treatment with ami-odarone could result in a reduction of the rate of deaths among patients treated for cardiac arrest resulting from VT/VF completing AMI (3, 4, 6). However, most data about amiodarone therapy for malignant ventricular arrhythmias result from studies investigating patients sustaining out-of-hospital cardiac arrest in a prehospital setting (3).