(/* ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) {{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=AC...)
(/* Management of Cardiac Arrest (DO NOT EDIT) {{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Preventi...)
| bgcolor="LightGreen"| <nowiki>"</nowiki>'''4.''' For victims with ventricular tachyarrhythmic mechanisms of [[cardiac arrest]], when recurrences occur after a maximally defibrillating shock (generally 360 J for monophasic defibrillators), intravenous [[amiodarone]] should be the preferred [[antiarrhythmic]] drug for attempting a stable rhythm after further defibrillations. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"| <nowiki>"</nowiki>'''4.''' For victims with ventricular tachyarrhythmic mechanisms of [[cardiac arrest]], when recurrences occur after a maximally defibrillating shock (generally 360 J for monophasic defibrillators), intravenous [[amiodarone]] should be the preferred [[antiarrhythmic]] drug for attempting a stable rhythm after further defibrillations. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
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| bgcolor="LightGreen"| <nowiki>"</nowiki>'''5.''' For recurrent [[ventricular tachyarrhythmias]] or nontachyarrhythmic mechanisms of [[cardiac arrest]], it is recommended to follow the algorithms contained in the documents on CPR<ref name="pmid16314375">{{cite journal| author=ECC Committee, Subcommittees and Task Forces of the American Heart Association| title=2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2005 | volume= 112 | issue= 24 Suppl | pages= IV1-203 | pmid=16314375 | doi=10.1161/CIRCULATIONAHA.105.166550 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16314375 }} </ref><ref name="pmid16321716">{{cite journal| author=Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G, European Resuscitation Council| title=European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. | journal=Resuscitation | year= 2005 | volume= 67 Suppl 1 | issue= | pages= S39-86 | pmid=16321716 | doi=10.1016/j.resuscitation.2005.10.009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16321716 }} </ref> developed by the AHA in association with ILCOR and/or the ERC. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"| <nowiki>"</nowiki>'''5.''' For recurrent [[ventricular tachyarrhythmias]] or non-tachyarrhythmic mechanisms of [[cardiac arrest]], it is recommended to follow the algorithms contained in the documents on CPR<ref name="pmid16314375">{{cite journal| author=ECC Committee, Subcommittees and Task Forces of the American Heart Association| title=2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2005 | volume= 112 | issue= 24 Suppl | pages= IV1-203 | pmid=16314375 | doi=10.1161/CIRCULATIONAHA.105.166550 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16314375 }} </ref><ref name="pmid16321716">{{cite journal| author=Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G, European Resuscitation Council| title=European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. | journal=Resuscitation | year= 2005 | volume= 67 Suppl 1 | issue= | pages= S39-86 | pmid=16321716 | doi=10.1016/j.resuscitation.2005.10.009 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16321716 }} </ref> developed by the AHA in association with ILCOR and/or the ERC. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
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| bgcolor="LightGreen"| <nowiki>"</nowiki>'''6.''' Reversible causes and factors contributing to [[cardiac arrest]] should be managed during advanced life support, including management of [[hypoxia]], [[Electrolyte disturbance|electrolyte disturbances]], mechanical factors, and [[volume depletion]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"| <nowiki>"</nowiki>'''6.''' Reversible causes and factors contributing to [[cardiac arrest]] should be managed during advanced life support, including management of [[hypoxia]], [[Electrolyte disturbance|electrolyte disturbances]], mechanical factors, and [[volume depletion]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
Long term anti-arrhythmic therapy may be indicated to prevent recurrence of VT. Beta-blockers and a number of class III anti-arrhythmics are commonly used.
For some of the rare congenital syndromes of VT, other drugs, and sometimes even catheter ablation therapy may be useful.
The implantation of an ICD is more effective than drug therapy for prevention of sudden cardiac death due to VT and VF, but may be constrained by cost issues, and well as patient co-morbidities and patient preference.
2006 ACC/AHA/ESC Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) [1]
"1. Ablation is indicated in patients who are otherwise at low risk for SCD and have sustained predominantly monomorphic VT that is drug resistant, who are drug intolerant, or who do not wish long-term drug therapy. (Level of Evidence: C) "
"3. Ablation is indicated as adjunctive therapy in patients with an ICD who are receiving multiple shocks as a result of sustained VT that is not manageable by reprogramming or changing drug therapy or who do not wish long-term drug therapy. (Level of Evidence: C)[2][3] "
"1. Ablation can be useful therapy in patients who are otherwise at low risk for SCD and have symptomatic nonsustained monomorphic VT that is drug resistant, who are drug intolerant or who do not wish long-term drug therapy.(Level of Evidence: C)"
" 2. Ablation can be useful therapy in patients who are otherwise at low risk for SCD and have frequent symptomatic predominantly monomorphic PVCs that are drug resistant or who are drug intolerant or who do not wish long-term drug therapy.(Level of Evidence: C)"
"1. After establishing the presence of definite, suspected, or impending cardiac arrest, the first priority should be activation of a response team capable of identifying the specific mechanism and carrying out prompt intervention. (Level of Evidence: B) "
"3. In an out-of-hospital setting, if an AED is available, it should be applied immediately and shock therapy administered according to the algorithms contained in the documents on CPR[7][8] developed by the AHA in association with the International Liaison Committee on Resuscitation (ILCOR) and/or the European Resuscitation Council (ERC). (Level of Evidence: C) "
"4. For victims with ventricular tachyarrhythmic mechanisms of cardiac arrest, when recurrences occur after a maximally defibrillating shock (generally 360 J for monophasic defibrillators), intravenous amiodarone should be the preferred antiarrhythmic drug for attempting a stable rhythm after further defibrillations. (Level of Evidence: B) "
" 1. For response times greater than or equal to 5 min, a brief (less than 90 to 180 s) period of CPR is reasonable prior to attempting defibrillation. (Level of Evidence: B ) "
"1. Patients presenting with sustained VT in whom low level elevations in cardiac biomarkers of myocyte injury/necrosis are documented should be treated similarly to patients who have sustained VT and in whom no biomarker rise is documented. (Level of Evidence: C)"
Sustained Monomorphic Ventricular Tachycardia (DO NOT EDIT) [1]
"1. Calcium channel blockers such as verapamil and diltiazem should not be used in patients to terminate wide-QRS-complex tachycardia of unknown origin, especially in patients with a history of myocardial dysfunction. (Level of Evidence: C) "
" 2. Intravenous amiodarone is reasonable in patients with sustained monomorphic VT that is hemodynamically unstable, refractory to conversion with countershock, or recurrent despite procainamide or other agents. (Level of Evidence: C) "
" 3. Transvenous catheter pace termination can be useful to treat patients with sustained monomorphic VT that is refractory to cardioversion or is frequently recurrent despite antiarrhythmic medication. (Level of Evidence: C) "
" 1. Intravenous lidocaine might be reasonable for the initial treatment of patients with stable sustained monomorphic VT specifically associated with acute myocardial ischemia or infarction. (Level of Evidence: C)"
Repetitive Monomorphic Ventricular Tachycardia (DO NOT EDIT) [1]
"1. Direct current cardioversion with appropriate sedation as necessary is recommended for patients with sustained polymorphic VT with hemodynamic compromise and is reasonable at any point in the treatment cascade. (Level of Evidence: B) "
"2. Intravenous beta blockers are useful for patients with recurrent polymorphic VT, especially if ischemia is suspected or cannot be excluded. (Level of Evidence: B) "
"3. Intravenous loading with amiodarone is useful for patients with recurrent polymorphic VT in the absence absence of abnormal repolarization related to congenital or acquired LQTS. (Level of Evidence: C) "
"4. Urgent angiography with a view to revascularization should be considered for patients with polymorphic VT when myocardial ischemia cannot be excluded. (Level of Evidence: C) "
" 1. Intravenous lidocaine may be reasonable for treatment of polymorphic VT specifically associated with acute myocardial ischemia or infarction. (Level of Evidence: C)"
"4.Isoproterenol is reasonable as temporary treatment in acute patients who present with recurrent pause-dependent torsades de pointes who do not have congenital LQTS. (Level of Evidence: B)"
"1.Catheter ablation is useful in patients with structurally normal hearts with symptomatic, drug-refractory VT arising from the RV or LV or in those who are drug intolerant or who do not desire long-term drug therapy. (Level of Evidence: C)"
"3.ICD implantation can be effective therapy for the termination of sustained VT in patients with normal or near normal ventricular function and no structural heart disease who are receiving chronic optimal medical therapy and who have reasonable expectation of survival for more than 1 y. (Level of Evidence: C)"
"1. High intermittent doses and cumulative doses exceeding the recommended levels should be avoided in patients receiving anthracyclines such as doxorubicin. (Level of Evidence: B)"
"2. All patients receiving 5-fluorouracil therapy should receive close supervision and immediate discontinuation of the infusion if symptoms or signs of myocardial ischemia occur. Further treatment with 5-fluorouracil must be avoided in these individuals. (Level of Evidence: C)"
↑Haïssaguerre M, Shoda M, Jaïs P, Nogami A, Shah DC, Kautzner J; et al. (2002). "Mapping and ablation of idiopathic ventricular fibrillation". Circulation. 106 (8): 962–7. PMID12186801.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)