Zipes et al
6.4.
6.5.
6.6.
6.7.
Have Recurrent Ventricular Tachycardia/Ventricular Fibrillation With Frequent Appropriate Implantable CardioverterDefibrillator Firing. . . . . . .e407 6.3.2.3. Patients With Implantable Cardioverter-Defibrillators Who Have Paroxysmal or Chronic Atrial Fibrillation With Rapid Rates and Inappropriate Implantable Cardioverter-Defibrillator Firing . . . . . . . . . . . . . . . . .e407 Nonantiarrhythmic Drugs . . . . . . . . . . . . . . . .e407 6.4.1. Electrolytes. . . . . . . . . . . . . . . . . . . . .e407 6.4.2. Antithrombins/Antiplatelets . . . . . . . .e408 6.4.3. n-3 Fatty Acids and Lipids . . . . . . . .e408 Implantable and External Cardioverter Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e408 6.5.1. Implantable Cardioverter-Defibrillator .e408 6.5.2. Automated External Defibrillator . . .e409 6.5.3. Wearable Automatic Defibrillator . . .e409 Ablation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e409 6.6.1. Catheter Ablation—Background . . . .e410 6.6.2. No Apparent Structural Heart Disease . . . . . . . . . . . . . . . . . . . . . . . .e410 6.6.3. Bundle-Branch Reentrant VT . . . . . .e410 6.6.4. Structural Heart Disease . . . . . . . . . .e410 6.6.5. Additional Ablation Tools . . . . . . . . .e410 Surgery and Revascularization Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . .e410 6.7.1. Antiarrhythmic Surgery . . . . . . . . . . .e411 6.7.2. Revascularization for Arrhythmia Management . . . . . . . . . . . . . . . . . . . .e411
7. ACUTE MANAGEMENT OF SPECIFIC ARRHYTHMIAS . . . . . . . . . . . . . . . . . . . . . . . . . . .e411 7.1. Management of Cardiac Arrest . . . . . . . . . . .e411 7.1.1. Arrhythmias Associated With Acute Coronary Syndromes . . . . . . . . . . . . .e414 7.1.1.1. Pulseless Ventricular Tachycardia/Ventricular Fibrillation . . . . . . . . . . . . .e415 7.1.1.2. Idioventricular Rhythm and Nonsustained Ventricular Tachycardia . . . . . . . . . . . .e415 7.1.1.3. Unstable Sustained Ventricular Tachycardia . . . . . . . . . . . .e415 7.1.1.4. Bradycardia and Heart Block.e415 7.1.2. Ventricular Tachycardia Associated With Low Troponin Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . .e415 7.2. Sustained Monomorphic Ventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . .e416 7.3. Repetitive Monomorphic Ventricular Tachycardia . . . . . . . . . . . . . . . . . . . . . . . . . . .e417 7.4. Polymorphic Ventricular Tachycardia . . . . . .e417 7.5. Torsades de Pointes . . . . . . . . . . . . . . . . . . . .e417 7.6. Incessant Ventricular Tachycardia . . . . . . . . .e418
ACC/AHA/ESC Practice Guidelines
e387
7.6.1. Clinical Features . . . . . . . . . . . . . . . .e418 7.6.2. Management . . . . . . . . . . . . . . . . . . . .e418 8. VENTRICULAR ARRHYTHMIA AND SUDDEN CARDIAC DEATH RELATED TO SPECIFIC PATHOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e419 8.1. Left Ventricular Dysfunction Due to Prior Myocardial Infarction . . . . . . . . . . . . . . . . . . .e419 8.1.1. Nonsustained Ventricular Tachycardia . . . . . . . . . . . . . . . . . . . .e420 8.1.2. Sustained Ventricular Tachycardia . .e420 8.1.3. Treatment of Ventricular Fibrillation and Cardiac Arrest Survivors . . . . . . . . . . . . . . . . . . . . . .e420 8.1.4. Primary Prevention of Sudden Cardiac Death. . . . . . . . . . . . . . . . . . .e420 8.1.5. Use of Implantable Cardioverter-Defibrillator for Ventricular Tachycardia in Patients With Normal or Near Normal Left Ventricular Ejection Fraction . . . . . . . . . . . . . . . . . .e421 8.2. Valvular Heart Disease . . . . . . . . . . . . . . . . . .e421 8.3. Congenital Heart Disease . . . . . . . . . . . . . . . .e422 8.4. Metabolic and Inflammatory Conditions . . . .e423 8.4.1. Myocarditis, Rheumatic Disease, and Endocarditis . . . . . . . . . . . . . . . . . . . .e423 8.4.1.1. Myocarditis. . . . . . . . . . . . .e423 8.4.1.2. Rheumatic Disease. . . . . . .e424 8.4.1.3. Endocarditis . . . . . . . . . . . .e424 8.4.2. Infiltrative Cardiomyopathies . . . . . .e425 8.4.2.1. Sarcoidosis . . . . . . . . . . . . .e425 8.4.2.2. Amyloidosis . . . . . . . . . . . .e425 8.4.2.3. Fabry Disease. . . . . . . . . . .e425 8.4.2.4. Hemochromatosis. . . . . . . .e426 8.4.3. Endocrine Disorders and Diabetes . .e426 8.4.3.1. Introduction . . . . . . . . . . . .e426 8.4.3.2. Thyroid Disorders . . . . . . .e426 8.4.3.3. Pheochromocytoma . . . . . .e426 8.4.3.4. Acromegaly . . . . . . . . . . . .e426 8.4.3.5. Primary Aldosteronism, Addison Disease, Hyperparathyroidism, and Hypoparathyroidism. . . . . .e426 8.4.3.6. Diabetes . . . . . . . . . . . . . . .e426 8.4.4. End-Stage Renal Failure . . . . . . . . . .e427 8.4.5. Obesity, Dieting, and Anorexia. . . . .e427 8.5. Pericardial Diseases . . . . . . . . . . . . . . . . . . . .e428 8.6. Pulmonary Arterial Hypertension. . . . . . . . . .e428 8.7. Transient Arrhythmias of Reversible Cause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .e428 9. VENTRICULAR ARRHYTHMIAS ASSOCIATED WITH CARDIOMYOPATHIES . . . . . . . . . . . . . . .e429 9.1. Dilated Cardiomyopathy (Nonischemic) . . . .e429 9.1.1. Risk Stratification . . . . . . . . . . . . . . .e430 9.1.2. Electrophysiological Testing . . . . . . .e430 9.1.3. Management . . . . . . . . . . . . . . . . . . . .e430 9.1.4. Genetic Analysis . . . . . . . . . . . . . . . .e431 9.2. Hypertrophic Cardiomyopathy . . . . . . . . . . . .e431 9.2.1. Risk Stratification . . . . . . . . . . . . . . .e432 9.2.2. Electrophysiological Testing . . . . . . .e432
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