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Ventricular Arrhythmias in Ischemic Heart Disease
- James N. Weiss, MD;
- Koonlawee Nademanee, MD;
- William G. Stevenson, MD; and
- Bramah Singh, MD, PhD
Abstract
Ventricular arrhythmias remain the leading cause of death from coronary artery disease. This review summarizes current thinking in several areas relating to the pathophysiology, prognosis, and therapy of ventricular arrhythmias associated with acute and chronic coronary artery disease syndromes. The experimental basis of arrhythmias in the setting of acute myocardial ischemia and chronic myocardial infarction is described, stressing the important pathophysiologic differences between these two conditions. The effects of the autonomic nervous system as a key modulator of ischemic arrhythmogenesis are discussed. Insights, derived from endocardial mapping studies, into the nature of ventricular tachycardia in humans with chronic myocardial infarction are described, including implications for risk stratification and therapy to prevent arrhythmia recurrence. Current therapeutic principles are discussed in the management of ventricular arrhythmias associated with coronary artery disease, including pharmacologic approaches, surgical and catheter ablation, and automatic implantable cardioverting and defibrillating devices.
Article and Author Information
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An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles, California. William M. Pardridge, MD, Professor of Medicine, is Director of Conferences.
Authors who wish to cite a section of the conference and specifically indicate its author can use this example as the form of the reference:
Singh BN. Principles of pharmacologic and nonpharmacologic therapy, pp. 792-795. In: Weiss JN, moderator. Ventricular arrhythmias in ischemic heart disease. Ann Intern Med. 1991;114:784-797.
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Grant Support: Dr. Weiss is the recipient of Research Career Development Award 1K04 HLO1890 from the National Institutes of Health.
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Requests for Reprints: James N. Weiss, MD, Department of Medicine, Division of Cardiology, UCLA School of Medicine, Los Angeles, CA 90024.
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Current Author Addresses: Drs. Weiss and Stevenson: Division of Cardiology, 47-123 CHS, UCLA School of Medicine, Los Angeles, CA 90024.
Dr. Nademanee: Division of Cardiology, Denver General Hospital, 77 Van Nock Street, Mail Code 0940, Denver, CO 80204.
Dr. Singh: Division of Cardiology, Wadsworth Veterans Affairs Medical Center, Mailcode 691-111E, Sawtelle Avenue and Wilshire Boulevard, Los Angeles, CA 90073-1691.
- © 1991 American College of Physicians
