[Pharmacological therapy and prevention of recurrent ventricular tachycardia]

Treatment of recurrent ventricular tachycardia (RVT) is still difficult, as far as choice of antiarrhythmic agents, dosage, associations and statement of their effectiveness are concerned; the Authors report their experience on twelve cases of RVT. The diagnosis of ventricular tachycardia was confirmed by esophageal electrograms in four cases and by intracardiac recordings in two cases. Patients were controlled by clinical observation, continuous electrocardiographic monitoring and several recordings. Ambulatory electrocardiographic monitoring was carried out in ten patients. Two patients left the hospital spontaneously; therapy was found to be effective in the remainder. Four patients were treated with quinidine plus betablockers, for cases with quinidine plus amiodarone. The results of long-term follow-up suggest that combined pharmacological therapy with drugs of different classes may be successful in preventing recurrences of ventricular tachycardia. The Authors think that careful choices of adequate therapeutic programs and rigid criteria for the evaluation of results should be planned in apparent refractory RVT, before referring to invasive procedures.