© 1999 European Society of Cardiology
Treatment of arrhythmias in heart failure
Department of Cardiological Sciences, St George's Hospital Medical School Cranmer Terrace, London SW17 ORE, UK
* Corresponding author. Tel.: +44-181-725-5916; fax: +44-181-767-7141 e-mail: pocallag@sghms.ac.uk
Key Words: Arrhythmia Antiarrhythmia agents Heart failure Death, sudden Defibrillation
Accepted April 7, 1999
| The first 150 words of the full text of this article appear below. |
| 1. Introduction |
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The last decade has seen major advances in the treatment of congestive heart failure and left ventricular systolic dysfunction. Nevertheless, despite conventional medical therapy including diuretics, digoxin, and angiotensin converting enzyme (ACE) inhibitors, the mortality rate associated with this condition remains unacceptably high, in the range of 5–15% annually in mild heart failure and increasing to 20–50% annually in patients with severe heart failure [1]. Angiotensin-converting enzyme (ACE) inhibitors reduce total mortality in patients with cardiac failure but in most trials do not reduce the frequency of ventricular arrhythmias or sudden cardiac death [2,3]. Sudden cardiac death is responsible for approximately half of all cardiac deaths in patients with heart failure. Sudden and unexpected death accounts for the majority of deaths in mild heart failure; in contrast death due to progressive pump failure accounts for the majority of deaths in severe heart failure (
| 2. Secondary prevention of life-threatening ventricular tacyhyarrhythmias |
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2.1. The decline of pharmacologic therapy
2.2. The rise of device therapy
| 3. Primary prevention of sudden cardiac death |
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3.1. Risk stratification and primary prevention
| 4. Conclusion |
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