Abstract
The treatment of arrhythmias involves consideration of patient symptoms, the clinical situation in which the arrhythmia arises, the natural history of a given arrhythmia, and the relative likelihood of success of different pharmacologic and invasive options such as device implantation, catheter ablation, or surgery. With advances in implantable cardiac devices and catheter ablation, the options for arrhythmia treatment have expanded significantly, and a basic understanding of these procedures is necessary to properly counsel patients on arrhythmia management. It is also important to understand the basic pharmacology of antiarrhythmic drugs, their indications, and their potential side effects and relative contraindications. An algorithmic approach to decision making while also taking into account individual patient preference and clinician experience is key. Thus, a structured approach to considering the different treatment modalities available for arrhythmias, when certain therapies may be reasonable, and how they may be implemented must be taken in the context of constantly evolving epidemiologic understanding and technological advances.
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Recommended Reading
Blomstrom-Lundqvist C, Scheinman MM, Aliot EM, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the European Society of Cardiology Committee for practice guidelines. J Am Coll Cardiol. 2003;42:1493–531.
Calkins H, Kuck KH, Cappato R, et al. HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Heart Rhythm. 2012;9(4):632–96.
Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2008;117:e350–408.
Natale A, Raviele A, Al-Ahmad A, et al. Venice chart international consensus document on ventricular tachycardia/ventricular fibrillation ablation. J Cardiovasc Electrophysiol. 2010;21:339–79.
Wann LS, Curtis AB, January CT, et al. ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline). Circulation. 2011;123:104–23.
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Kapa, S., Marchlinski, F.E. (2013). Treatment of Cardiac Arrhythmias. In: Rosendorff, C. (eds) Essential Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6705-2_16
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DOI: https://doi.org/10.1007/978-1-4614-6705-2_16
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