Survey of physician practices in managing patients with chronic ventricular arrhythmias

To better understand how physicians manage patients with chronic ventricular arrhythmias, questionnaires were mailed in July, 1989, to 680 internists, family physicians and cardiologists in West Virginia. Responses were returned by 35 per cent; those from 33 physicians who seldom prescribed drugs to treat arrhythmias were excluded from analysis. Quinidine and procainamide were the preferred first-line antiarrhythmics for 53.3 per cent and 24.3 per cent of physicians, respectively. Control of symptoms was listed as the usual indication for therapy by 32.2 per cent, and improvement in prognosis by 20.1 per cent. Physicians perceived a high prognostic benefit to antiarrhythmic treatment in patients with sustained ventricular tachycardia or history of cardiac arrest, and a generally low prognostic benefit in those with mitral valve prolapse. Opinion was divided on the prognostic benefit in other patient groups including those with frequent ventricular premature beats following myocardial infarction. These results help quantify current physician practices in managing patients with chronic ventricular arrhythmias.