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European Heart Journal 1989 10(Supplement E):53-60; doi:10.1093/eurheartj/10.suppl_E.53
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Ventricular arrhythmias: control of therapy by Holter monitoring

L. N. Horowitz

Philadelphia Heart Institute, Presbyterian University of Pennsylvania Medical Center Philadelphia, Pennsylvania, U.S. A.

Address for correspondence: correspondence: Leonard N. Horowitz M.D., Philadelphia Heart Institute, Presbyterian Medical Center of Philadelphia, 39th and Market Streets, Philadelphia, PA 19104, U.S.A.

Ventricular arrhythmias can be classified into categories based on the risk of sudden death associated with them. Patients with benign ventricular arrhythmias are those with minimal or no heart disease and normal ventricular function. Arrhythmias encountered in this group include ventricular premature complexes and unsustained ventricular tachycardia. In patients with prognostically signiJicant ventricular arrhythmia, the arrhythmias are the same, namely, ventricularpremature complexes andlor unsustained ventricular tachycardia. This group differs, however, in that the patients have organic heart disease and the risk of the arrhythmia increases as left ventricular function decreases. Patients with malignant ventricular arrhythmia, sustained ventricular tachycardia and ventricularjbrillation have the highest risk of sudden death. While no conclusivestudies are available, some studies do suggest that the suppression of ambient ventricular arrhythmia asdocumented by Holter monitoring (and possibly exercise testing) identifies antiarrhythmic regimens which are effective in preventing sudden death. Variability in the frequency of ambient ventricular ectopy must beconsidered in assessing both eficacy and toxicity of antiarrhythmic regimens. Holter monitoring may also be useful in assessing the substrate of malignant ventricular arrhythmias and autonomic tone.

Key Words: Ventriculararrhythmia • antiarrhythmic therapy • suddencardiacdeath • Holter monitoring • ventricular premature complexes • unsustained ventricular tachycardia


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