PVCs in the elderly: when to start worrying

Recent studies using electrophysiologic testing have established that effective antiarrhythmic therapy does indeed prolong survival in the high-risk group of survivors of out-of-hospital cardiac arrest. Ideally, the initial antiarrhythmic agent is selected on the basis of its efficacy, side effects, ease of administration, cost, and interaction with other medications. To a large extent, however, selection remains empiric. In patients without QT prolongation, long-acting procainamide or quinidine are usually tried first.