Management of chronic ventricular arrhythmias

Premature ventricular contractions occurring in asymptomatic patients without heart disease are benign and need not be treated. Beta blockers may be used for symptomatic patients. Antiarrhythmic therapy for patients after myocardial infarction is controversial; authors of recent studies have tended to discourage this therapy. Patients with malignant arrhythmias--who have been resuscitated from cardiac arrest caused by ventricular ectopy or who have ventricular tachycardia-associated syncope--should be referred for electrophysiologic testing and individualized therapy.