Drugs, Surgery, Cardioverter Defibrillator: A Decision Based on the Clinical Problem.
Saved in:
| Title: | Drugs, Surgery, Cardioverter Defibrillator: A Decision Based on the Clinical Problem. |
|---|---|
| Authors: | Capucci, Alessandro1, Boriani, Giuseppe1 |
| Source: | Pacing & Clinical Electrophysiology. Mar1993, Vol. 16 Issue 3, p519-526. 8p. |
| Subjects: | Implantable cardioverter-defibrillators, Implanted cardiovascular instruments, Drugs, Surgery, Myocardial depressants, Ventricular fibrillation, Cardiac arrest |
| Abstract: | These three therapeutic options are the basis of sudden cardiac death prevention: antiarrhythmic drugs, surgery, and automatic implantable cardioverter defibrillator. Each of these treatments has specific favorable and unfavorable indications. Antiarrhythmic drugs are mainly limited by the low therapeutic profile, proarrhythmic effects, complex pharmacokinetics and pharmacodynamics, possible negative inotropic effects, and the possible change of the organic substratum. Arrhythmia surgery may be limited by the need of a highly trained center, by a relatively high perioperative mortality (up to 15%), and by limited electrophysiological and clinical indications. The implantable cardioverter defibrillator is an expensive tool with a theoretically wide range of clinical indications, with already proven efficacy in converting ventricular fibrillation to sinus rhythm but with unproven efficacy on prolonging survival because of a lack of controlled trials (which, we must admit, is also true for drugs and surgery). The results of the ongoing multicenter trials on this item will clarify this clinical point. The choice among these different therapeutic options is mainly based on hemodynamic status (ejection fraction), feasibility of a surgical treatment, and the electrophysiological characteristics of the ventricular arrhythmia. [ABSTRACT FROM AUTHOR] |
| Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
|---|---|
| Header | DbId: egs DbLabel: Engineering Source An: 17563935 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Drugs, Surgery, Cardioverter Defibrillator: A Decision Based on the Clinical Problem. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Capucci%2C+Alessandro%22">Capucci, Alessandro</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Boriani%2C+Giuseppe%22">Boriani, Giuseppe</searchLink><relatesTo>1</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pacing+%26+Clinical+Electrophysiology%22">Pacing & Clinical Electrophysiology</searchLink>. Mar1993, Vol. 16 Issue 3, p519-526. 8p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Implantable+cardioverter-defibrillators%22">Implantable cardioverter-defibrillators</searchLink><br /><searchLink fieldCode="DE" term="%22Implanted+cardiovascular+instruments%22">Implanted cardiovascular instruments</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs%22">Drugs</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Myocardial+depressants%22">Myocardial depressants</searchLink><br /><searchLink fieldCode="DE" term="%22Ventricular+fibrillation%22">Ventricular fibrillation</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+arrest%22">Cardiac arrest</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: These three therapeutic options are the basis of sudden cardiac death prevention: antiarrhythmic drugs, surgery, and automatic implantable cardioverter defibrillator. Each of these treatments has specific favorable and unfavorable indications. Antiarrhythmic drugs are mainly limited by the low therapeutic profile, proarrhythmic effects, complex pharmacokinetics and pharmacodynamics, possible negative inotropic effects, and the possible change of the organic substratum. Arrhythmia surgery may be limited by the need of a highly trained center, by a relatively high perioperative mortality (up to 15%), and by limited electrophysiological and clinical indications. The implantable cardioverter defibrillator is an expensive tool with a theoretically wide range of clinical indications, with already proven efficacy in converting ventricular fibrillation to sinus rhythm but with unproven efficacy on prolonging survival because of a lack of controlled trials (which, we must admit, is also true for drugs and surgery). The results of the ongoing multicenter trials on this item will clarify this clinical point. The choice among these different therapeutic options is mainly based on hemodynamic status (ejection fraction), feasibility of a surgical treatment, and the electrophysiological characteristics of the ventricular arrhythmia. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pacing & Clinical Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=17563935 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/j.1540-8159.1993.tb01619.x Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 519 Subjects: – SubjectFull: Implantable cardioverter-defibrillators Type: general – SubjectFull: Implanted cardiovascular instruments Type: general – SubjectFull: Drugs Type: general – SubjectFull: Surgery Type: general – SubjectFull: Myocardial depressants Type: general – SubjectFull: Ventricular fibrillation Type: general – SubjectFull: Cardiac arrest Type: general Titles: – TitleFull: Drugs, Surgery, Cardioverter Defibrillator: A Decision Based on the Clinical Problem. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Capucci, Alessandro – PersonEntity: Name: NameFull: Boriani, Giuseppe IsPartOfRelationships: – BibEntity: Dates: – D: 15 M: 03 Text: Mar1993 Type: published Y: 1993 Identifiers: – Type: issn-print Value: 01478389 Numbering: – Type: volume Value: 16 – Type: issue Value: 3 Titles: – TitleFull: Pacing & Clinical Electrophysiology Type: main |
| ResultId | 1 |
