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• W2223367221 abstract "Sudden death is responsible for 20-80% of total mortality in heart failure patients. The arrhythmia risk stratification is weak, mainly in idiopathic cardiomyopathy. Several pharmacologic and non-pharmacologic forms of treatment are currently being used aiming lower mortality rates. Class I antiarrhtymic drugs are very proarrhtymic in these patients and should not be used. The amiodarone’s role in preventing death is not well defined. Several nonarrhytmic drugs have shown to decrease mortality: ACE inhibitors, beta-blockers, spironolactone. Among the nonpharmacologic measures that are being used, implantable cardioverter-defibrillators have shown to be the most effucaceous. Clinical trials have shown that cardioverter-defibrillators decrease arrhythmic and total mortality in primary and secondary prevention in heart failure patients. Another terapheutic method that can be eventually used is the radiofrequency ablation. In summary, heart failure patients present high risk of ventricular arrhytmias, the risk stratification is not optimal, but several pharmacologic and non pharmacologic forms of treatment are being able to decrease ventricular tachyarrhytmias and mortality in these patients. DESCRIPTORS: heart failure, ventricular arrhythmias, implantable cardioverter-defibrillator. Reblampa 78024-283 REFERENCIAS BIBLIOGRAFICAS 1 Cleland J, Dargie H, Ford I. Mortality in heart failure: clinical variables of prognostic value. Br Heart J 1987; 58: 572-82. 2 Kjekshus J. Arrhythmias and mortality in congestive heart failure. Am J Cardiol 1990; 5: 42I-81. 3 Merit-HF. Study Group. Effect of Metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL randomized intervention trial in congestive heart failure (MERIT HF). Lancet 1999; 353: 2001-7. 4 Schmidinger H. The implantable cardioverter defibrillator as a “bridge to transplant”: a viable clinical strategy?. Am J Cardiol 1999; 83: 151D-7D. 5 Teerlink J, Jalaluddin M, Anderson S, et al. Ambulatory ventricular arrhythmias in patients with heart failure do not specifically predict an increased risk of sudden death. Circulation 2000; 101: 40-6. 6 Stevenson W. Stevenson L. Middlekauff H., et al. Improving survival for patients with advanced heart failure: a study of 737 consecutive patients. J Am Coll Cardiol 1995; 26: 1417-23. 7 Echt D, Liebson P, Mitchell B, et al. Mortality and morbidity in patients receiving encainide, flecainide or placebo: The Cardiac Arrhythmia Supression Trial. N Engl J Med 1991; 324: 781-8. 8 Flaker G, Blackshear J, McBride R, et al. Antiarrhythmic drug therapy and cardiac mortality in atrial fibrillation. J Am Coll Cardiol 1999; 20: 527-32. 9 Cohn J, Archibald D, Ziesche S, et al. Effect of vasodilator therapy on mortality in chronic heart failure: Results of a Veterans Administration Cooperative Study (V-HeFT). N Engl J Med 1986; 314: 1547-52. 10 Packer M, Bristow M, Cohn J, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996; 334: 1349-55. 11 CIBIS II Investigators and Committees. The cardiac insufficiency bisoprolol study II (CIBIS II): a randomised trial. Lancet 1999; 353: 9-13." @default.
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• W2223367221 date "2000-10-01" @default.
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• W2223367221 title "Tratamento de Arritmias Ventriculares em Pacientes com Insuficiência Cardíaca" @default.
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