Premature ventricular contraction medical therapy: Difference between revisions
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==2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>== | ==2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>== | ||
=== Recommendation for Pharmacological Prevention of Sudden | === Recommendation for Pharmacological Prevention of Sudden Cardiac Death (SCD) === | ||
{|class="wikitable" | {|class="wikitable" | ||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ESC Guidelines Classification Scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki></nowiki>'''1.''' In patients with HFrEF (LVEF ≤40%), treatment with a beta blocker, a mineralocorticoid receptor antagonist and either an angiotensin-converting enzyme inhibitor, an angiotensin-receptor blocker, or an angiotensin receptor-neprilysin inhibitor is recommended to reduce SCD and all-cause mortality ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''.<ref name="YancyJessup2016">{{cite journal|last1=Yancy|first1=Clyde W.|last2=Jessup|first2=Mariell|last3=Bozkurt|first3=Biykem|last4=Butler|first4=Javed|last5=Casey|first5=Donald E.|last6=Colvin|first6=Monica M.|last7=Drazner|first7=Mark H.|last8=Filippatos|first8=Gerasimos|last9=Fonarow|first9=Gregg C.|last10=Givertz|first10=Michael M.|last11=Hollenberg|first11=Steven M.|last12=Lindenfeld|first12=JoAnn|last13=Masoudi|first13=Frederick A.|last14=McBride|first14=Patrick E.|last15=Peterson|first15=Pamela N.|last16=Stevenson|first16=Lynne Warner|last17=Westlake|first17=Cheryl|title=2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America|journal=Circulation|volume=134|issue=13|year=2016|issn=0009-7322|doi=10.1161/CIR.0000000000000435}}</ref><ref>{{Cite journal | | bgcolor="LightGreen"|<nowiki></nowiki>'''1.''' In [[patients]] with [[HFrEF]] ([[LVEF]] ≤40%), [[Therapy|treatment]] with a [[beta blocker]], a [[Mineralocorticoid receptor|mineralocorticoid receptor antagonist]] and either an [[angiotensin-converting enzyme inhibitor]], an [[Angiotensin receptor blocker|angiotensin-receptor blocker]], or an [[angiotensin receptor]]-[[neprilysin]] inhibitor is recommended to reduce [[SCD]] and all-cause [[mortality]] ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: A]])''.<ref name="YancyJessup2016">{{cite journal|last1=Yancy|first1=Clyde W.|last2=Jessup|first2=Mariell|last3=Bozkurt|first3=Biykem|last4=Butler|first4=Javed|last5=Casey|first5=Donald E.|last6=Colvin|first6=Monica M.|last7=Drazner|first7=Mark H.|last8=Filippatos|first8=Gerasimos|last9=Fonarow|first9=Gregg C.|last10=Givertz|first10=Michael M.|last11=Hollenberg|first11=Steven M.|last12=Lindenfeld|first12=JoAnn|last13=Masoudi|first13=Frederick A.|last14=McBride|first14=Patrick E.|last15=Peterson|first15=Pamela N.|last16=Stevenson|first16=Lynne Warner|last17=Westlake|first17=Cheryl|title=2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America|journal=Circulation|volume=134|issue=13|year=2016|issn=0009-7322|doi=10.1161/CIR.0000000000000435}}</ref><ref>{{Cite journal | ||
| title = The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial | | title = The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial | ||
| journal = [[Lancet (London, England)]] | | journal = [[Lancet (London, England)]] | ||
Revision as of 21:33, 21 April 2020
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Premature ventricular contraction Microchapters |
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Differentiating Premature Ventricular Contraction from other Disorders |
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Diagnosis |
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Treatment |
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Case Studies |
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Premature ventricular contraction medical therapy On the Web |
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Premature ventricular contraction medical therapy in the news |
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to Hospitals Treating Premature ventricular contraction medical therapy |
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Risk calculators and risk factors for Premature ventricular contraction medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Homa Najafi, M.D.[2] Mugilan Poongkunran M.B.B.S [3]
Overview
Isolated premature ventricular contractions with benign characteristics require no treatment. In healthy individuals, PVCs can often be resolved by restoring the balance of magnesium, calcium and potassium within the body.
Medical Therapy
- Pharmacological agents
- Antiarrhythmics: these agents alter the electrophysiologic mechanisms responsible for PVCs.
- Beta blocker : Propranolol, atenolol, metoprolol
- Calcium channel blockers
- Electrolytes replacement
- Magnesium supplements (e.g. magnesium citrate, orotate, Maalox, etc.)
- Potassium supplements
Therapies with limited data to support their use:
In the setting of existing cardiac disease, however, PVCs must be watched carefully, as they may cause a form of ventricular tachycardia (rapid heartbeat).
2017 AHA/ACC/HRS Guideline for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT)[1]
Recommendation for Pharmacological Prevention of Sudden Cardiac Death (SCD)
| Class I |
| 1. In patients with HFrEF (LVEF ≤40%), treatment with a beta blocker, a mineralocorticoid receptor antagonist and either an angiotensin-converting enzyme inhibitor, an angiotensin-receptor blocker, or an angiotensin receptor-neprilysin inhibitor is recommended to reduce SCD and all-cause mortality (Level of Evidence: A).[2][3][4][5][6][7][8][9] |
References
- ↑ Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". Circulation. 138 (13). doi:10.1161/CIR.0000000000000549. ISSN 0009-7322.
- ↑ Yancy, Clyde W.; Jessup, Mariell; Bozkurt, Biykem; Butler, Javed; Casey, Donald E.; Colvin, Monica M.; Drazner, Mark H.; Filippatos, Gerasimos; Fonarow, Gregg C.; Givertz, Michael M.; Hollenberg, Steven M.; Lindenfeld, JoAnn; Masoudi, Frederick A.; McBride, Patrick E.; Peterson, Pamela N.; Stevenson, Lynne Warner; Westlake, Cheryl (2016). "2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America". Circulation. 134 (13). doi:10.1161/CIR.0000000000000435. ISSN 0009-7322.
- ↑ "The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial". Lancet (London, England). 353 (9146): 9–13. 1999. PMID 10023943. Unknown parameter
|month=ignored (help) - ↑ Cohn, Jay N.; Johnson, Gary; Ziesche, Susan; Cobb, Frederick; Francis, Gary; Tristani, Felix; Smith, Raphael; Dunkman, W. Bruce; Loeb, Henry; Wong, Maylene; Bhat, Geetha; Goldman, Steven; Fletcher, Ross D.; Doherty, James; Hughes, C. Vincent; Carson, Peter; Cintron, Guillermo; Shabetai, Ralph; Haakenson, Clair (1991). "A Comparison of Enalapril with Hydralazine–Isosorbide Dinitrate in the Treatment of Chronic Congestive Heart Failure". New England Journal of Medicine. 325 (5): 303–310. doi:10.1056/NEJM199108013250502. ISSN 0028-4793.
- ↑ Packer, Milton; Bristow, Michael R.; Cohn, Jay N.; Colucci, Wilson S.; Fowler, Michael B.; Gilbert, Edward M.; Shusterman, Neil H. (1996). "The Effect of Carvedilol on Morbidity and Mortality in Patients with Chronic Heart Failure". New England Journal of Medicine. 334 (21): 1349–1355. doi:10.1056/NEJM199605233342101. ISSN 0028-4793.
- ↑ "Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial". The Lancet. 357 (9266): 1385–1390. 2001. doi:10.1016/S0140-6736(00)04560-8. ISSN 0140-6736.
- ↑ Pitt, Bertram; Remme, Willem; Zannad, Faiez; Neaton, James; Martinez, Felipe; Roniker, Barbara; Bittman, Richard; Hurley, Steve; Kleiman, Jay; Gatlin, Marjorie (2003). "Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction". New England Journal of Medicine. 348 (14): 1309–1321. doi:10.1056/NEJMoa030207. ISSN 0028-4793.
- ↑ Al Chekakie, M. Obadah (2013). "Traditional Heart Failure Medications and Sudden Cardiac Death Prevention". Journal of Cardiovascular Pharmacology and Therapeutics. 18 (5): 412–426. doi:10.1177/1074248413491496. ISSN 1074-2484.
- ↑ Pfeffer, Marc A.; McMurray, John J.V.; Velazquez, Eric J.; Rouleau, Jean-Lucien; Køber, Lars; Maggioni, Aldo P.; Solomon, Scott D.; Swedberg, Karl; Van de Werf, Frans; White, Harvey; Leimberger, Jeffrey D.; Henis, Marc; Edwards, Susan; Zelenkofske, Steven; Sellers, Mary Ann; Califf, Robert M. (2003). "Valsartan, Captopril, or Both in Myocardial Infarction Complicated by Heart Failure, Left Ventricular Dysfunction, or Both". New England Journal of Medicine. 349 (20): 1893–1906. doi:10.1056/NEJMoa032292. ISSN 0028-4793.