Decisions in the Treatment of Ventricular Ectopic Activity

EACH use of an antiarrhythmic agent for control of ventricular ectopic activity requires careful consideration of the balance between the indication for use of the drug (based on prognostic implications of ventricular ectopic activity) and undesirable potential side effects that may arise as a result of their use. Side effects include allergic or toxic systemic effects, depression of cardiac mechanical function, paradoxical arrhythmogenesis, and CNS effects; they occur with sufficient frequency, in the context of the limited number of drugs available, to create legitimate concern about appropriate use. The purpose of this communication is to outline settings in which antiarrhythmic agents should or should not be used for various forms of ventricular ectopic activity. The clinical context of ventricular ectopic activity is paramount. Ischemic Heart Disease Ventricular ectopic activity in the setting of ischemic heart disease constitutes a risk factor for potentially lethal arrhythmias or sudden death. The effectiveness of