Pharmacological vs. Automatic Implantable Cardioverter-Defibrillator in Treatment of Ventricular Tachycardia and/or Ventricular Fibrillation.
Patients continue to die each year from ventricular arrhythmia, accounting for less than 1 percent of all those in western countries dying suddenly. Following the primary event, patients continue to present a high risk for tachyarrhythmia to follow (Cappato, 1999). Pinski, Yao, Epstein, Greene, Pacifico, Cook, Jadonath, Marinchak, and the AVID Investigators (AVID) (2000) reported that while research has attempted to establish outcomes of sustained ventricular tachyarrhythmias, with regard to treatment, findings remain inconclusive.
Treatments thus far have included the use of antiarrhythmic drugs and implantable cardioverter defibrillators (ICDs) in addition to treating the underlying disease. Drug treatments are limited by the potential harm associated and more recent studies have shown that class I antiarrhythmic drugs are less effective than class III drugs for those patients with ventricular arrhythmia. Other reports have shown that ICDs have resulted in decreases in sudden cardiac death for those patients with sustained ventricular arrhythmia. However, researchers continue to debate whether this evidence translates into a reduction in total mortality. The major randomized studies researching the differences between outcomes of antiarrhythmics versus implantable defibrillators, include the Antiarrhythmic Versus Implantable Defibrillator trial (AVID), the Cardiac Arrest Study Hamburg (CASH), the Canadian Implantable Defibrillator Study (CIDS), and the Dutch Study (Cappato, 1999).
Since findings are reported to remain inconclusive, the goal of this research paper is to present an integrated review of the literature related to pharmacological versus automatic implantable cardioverter-defibrillator in treatment of ventricular tachycardia (VT) and/or ventricular fibrillation (VF)...