Skip to main content
SpringerLink
Log in

Approach to the Patient with Ventricular Tachycardia or Ventricular Fibrillation

  • Chapter
Management of Cardiac Arrhythmias

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 119 Accesses

Abstract

Cardiac arrest is the cause of more than 300,000 deaths annually, mostly associated with coronary-artery disease (CAD) (1). Ventricular tachyarrhythmias are reported in approximately 75% of these cases, with polymorphic ventricular tachycardia (PVT), ventricular fibrillation (VF) and monomorphic ventricular tachycardia (VT) observed with nearly equal frequency (2). VT and VF are therefore the leading causes of death in patients with coronary-artery disease. The approach to the patient with VT or VF requires a careful evaluation of the clinical history, mode of presentation, underlying cardiac substrate, and ventricular function. For patients who present with VT, electrocardiographic documentation is extremely important. Although most arrhythmic episodes occur in unmonitored settings, the 12-lead electrocardiogram (ECG) provides valuable diagnostic and prognostic information. The fact that a 12-lead ECG could be recorded during the event generally implies that VT is tolerated by the patient. Secondly, the probable diagnosis of right ventricular outflow-tract (RVOT) tachycardia (Fig. 1) and idiopathic left ventricular tachycardia (Fig. 2) is based upon a characteristic morphology recorded on the ECG. Thirdly, the ECG identifies the region of origin for the exit site of VT when ablative therapy is considered. Finally, in some patients, wide-complex tachycardia will be caused by supraventricular tachycardia (SVT) with aberrancy rather than VT; an ECG can be helpful in making this diagnosis. Only after complete assessment of relevant clinical data can a proper therapeutic decision be made regarding the treatment of VT. For patients who are resuscitated from VF, a 12-lead ECG obtained post-resuscitation may offer clues to the cause of the arrest (such as acute myocardial infarction (MI), long QT syndrome (LQTS), or Wolff-Parkinson-White syndrome (WPW)).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Myerburg R, Kessler KM, Castellanos A. Sudden cardiac death: epidemiology, transient risk, and intervention assessment. Ann Intern Med 1993; 119: 1187–1197.

    Article  PubMed  CAS  Google Scholar 

  2. DiMarco JP, Haines DE. Sudden cardiac death. Curr Probl Cardiol 1990: 187–232.

    Google Scholar 

  3. The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 1997; 337: 1576–1583.

    Article  Google Scholar 

  4. Stevenson WG, Friedman PL. Catheter Ablation of Ventricular Tachycardia. In: Zipes DP, Jalife J. Cardiac Electrophysiology: From Cell to Bedside, 3rd ed. WB Saunders Co., Philadelphia, PA, 2000, pp. 1049–1056.

    Google Scholar 

  5. Mirowski M. The Automatic implantable cardioverter-defibrillator: an overview. J Am Coll Cardio 1985; 6: 461–466.

    Article  CAS  Google Scholar 

  6. Gregoratos G, Cheitlin M, Conill A, et al. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices. J Am Coll Cardiol 1998; 31: 1175–1209.

    Article  PubMed  CAS  Google Scholar 

  7. Karagueuzian HS, Mandel WJ. Electrophysiologic Mechanisms of Ischemic Ventricular Arrhythmias: Experimental and Clinical Correlations. In: Mandel WJ. Cardiac Arrhythmias: Their Mechanisms, Diagnosis, and Management. J.B. Lippincott Company, Philadelphia, PA, 1995, pp. 563–603.

    Google Scholar 

  8. The Multicenter Postinfarction Research Group. Risk Stratification and Survival After Myocardial Infarction. N Engl J Med 1983; 309: 331–336.

    Article  Google Scholar 

  9. Bigger JT, Fleiss JL, Kleiger R, et al. The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation 1984; 69: 250–258.

    Article  PubMed  Google Scholar 

  10. Sanz G, Castaner A, Betriu A, et al. Determinants of prognosis in survivors of myocardial infarction. N Engl J Med 1982; 306: 1065–1070.

    Article  PubMed  CAS  Google Scholar 

  11. Mukharji J, Rude R, Poole W, et al. Risk factors for sudden death after acute myocardial infarction: two-year follow-up. Am J Cardiol 1984; 54: 31–36.

    Article  PubMed  CAS  Google Scholar 

  12. Richards D, Byth K, Ross D, et al. What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction. Circulation 1991; 83: 756–763.

    Article  PubMed  CAS  Google Scholar 

  13. Pedretti R, Etro M, Laporta A, et al. Prediction of late arrhythmic events after acute myocardial infarction from combined use of non-invasive prognostic variables and inducibility of sustained monomorphic ventricular tachycardia. Am J Cardiol 1993; 71: 1131–1141.

    Article  PubMed  CAS  Google Scholar 

  14. Denniss AR, Richards DA, Cody DV, et al. Prognostic significance of ventricular tachycardia and fibrillation induced at programmed stimulation and delayed potentials detected on the signal-averaged electrocardiograms of survivors of acute myocardial infarction. Circulation 1986; 74: 731–745.

    Article  PubMed  CAS  Google Scholar 

  15. Kuchar DL, Thorburn CW, Sammel NL. Prediction of serious arrhythmic events after myocardial infarction: signal-averaged electrocardiogram, holter monitoring and radionuclide ventriculography. J Am Coll Cardiol 1987; 9: 531–538.

    Article  PubMed  CAS  Google Scholar 

  16. Moss A, Hall W, Cannom D, et al., for the Multicenter Automatic Defibrillator Implantation Trial (MADIT) Investigators. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996; 335: 1933–1940.

    Google Scholar 

  17. The B-Blocker Heart Attack Trial Research Group. A randomized trial of propranolol in patients with acute myocardial infarction. JAMA 1982; 247: 1707–1714.

    Article  Google Scholar 

  18. The Norwegian Multicenter Study Group. Timolol-induced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 1981; 304: 801–807.

    Article  Google Scholar 

  19. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med 1987; 316: 1429–1435.

    Article  Google Scholar 

  20. The SOLVD Investigators. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med 1991; 325: 293–302.

    Article  Google Scholar 

  21. Cohn J, Johnson G, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med 1991; 325: 303–310.

    Article  PubMed  CAS  Google Scholar 

  22. Pfeffer M, Braunwald E, Moye L, et al. for the Survival and Ventricular Enlargement Trial (SAVE) Investigators. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1992; 327: 669–677.

    Google Scholar 

  23. a.Kober L, Torp-Pederson C, Carlsen JE, et al. A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1995; 333: 1670–1676.

    Google Scholar 

  24. b.Domanski MJ, Exner DV, Borkowf CB, Geller NL, Rosenberg Y, Pfeffer MA. Effect of angiotensin converting enzyme inhibition on sudden cardiac death inpatients following acute myocardial infarction: A meta-analysis of randomized clinical trials. J Am Coll Cardiol 1999; 33: 598–604.

    Article  Google Scholar 

  25. Echt D, Liebson P, Mitchell B, et al., for the Cardiac Arrhythmia Suppression Trial (CAST) Investigators. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. N Engl J Med 1991; 324: 781–788.

    Article  PubMed  CAS  Google Scholar 

  26. Teo K, Yusuf S, Furber C. Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction: an overview of results from randomized controlled trial. JAMA 1993; 270: 1589–1595.

    Article  PubMed  CAS  Google Scholar 

  27. Burkart F, Pfisterer M, Kiowski W, et al. Effect of antiarrhythmic therapy on mortality in survivors of myocardial infarction with asymptomatic complex ventricular arrhythmias: Basel Antiarrhythmic Study of Infarct Survival (BASIS). J Am Coll Cardiol 1990; 16: 1711–1718.

    Article  PubMed  CAS  Google Scholar 

  28. Singh S, Fletcher R, Fisher S, et al. for the Survival Trail of Antiarrhythmic Therapy in Congestive Heart Failure (CHF-STAT) Investigators. Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. N Engl J Med 1995; 333: 77–82.

    Article  PubMed  CAS  Google Scholar 

  29. Julian D, Camm A, Frangin G, et al. for the European Myocardial Infarct Amiodarone Trial (EMIAT) Investigators. Randomized trial of effect of amiodarone on mortality in patients with left ventricular dysfunction after recent myocardial infarction: EMIAT. Lancet 1997; 349: 667–674.

    Article  PubMed  CAS  Google Scholar 

  30. Cairns J, Connolly S, Roberts R, et al. for the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial (CAMIAT) Investigators. Lancet 1997; 349: 675–682.

    Article  PubMed  CAS  Google Scholar 

  31. a.Amiodarone Trials Meta-Analysis Investigators. Effect of prophylactic amiodarone on mortality after acute myocardial infarction and in congestive heart failure: meta-analysis of individual data from 6500 patients in randomized trials. Lancet 1997; 350: 1417–1423.

    Article  Google Scholar 

  32. Waldo A, Camm A, deRuyter H, et al. For the Survival With Oral d-Sotalol (SWORD) Investigators. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Lancet 1996; 348: 7–12.

    Article  PubMed  CAS  Google Scholar 

  33. Bigger J, for the Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. Prophylactic use

    Google Scholar 

  34. of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary artery bypass graft surgery. N Engl J Med 1997; 337: 1569–1575.

    Article  Google Scholar 

  35. Bigger JT Jr, Whang W, Rottman JN, etal. Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. Circulation 1999; 99: 1416–1421.

    Article  PubMed  Google Scholar 

  36. Buxton A, Fisher J, Josephson M, et al. for the Multicenter Unsustained Tachycardia Trial (MUSTT) Investigators. Prevention of sudden death in patients with coronary artery disease: the Multicenter Unsustained Tachycardia Trial (MUSTT). Prog Cardiovasc Dis 1993; 36: 215–226.

    Article  PubMed  CAS  Google Scholar 

  37. Buxton AE, Lee KL, Fisher JD, et al. for the Multicenter Unsustained Tachycardia Trial Investigators. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 1999; 341: 1882–1890.

    Article  PubMed  CAS  Google Scholar 

  38. a.Buxton AE, Lee KL, DiCarlo L, et al. Electrophysiologic testing to identify patients with coronary artery disease who are at risk for sudden death. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med 2000 Jun 29; 342 (26): 1937–1945.

    Article  Google Scholar 

  39. Klein H, Auricchio A, Reek Sven, et al. New Primary Prevention trial of Sudden Cardiac Death in Patients with Left Ventricular Dysfunction: SCD-HEFT and MADIT-II. Am J Cardiol 1999;83:91D– 97D.

    Google Scholar 

  40. Gilman J, Jalal S, Naccarelli G. Predicting and preventing sudden death from cardiac causes. Circulation 1994; 90: 1083–1092.

    Article  PubMed  CAS  Google Scholar 

  41. Domanski M, Zipes D, Schron E. Treatment of sudden cardiac death. Circulation 1997; 95: 2694–2699.

    Article  PubMed  CAS  Google Scholar 

  42. Cannom D, Prystowski E. Management of ventricular arrhythmias. JAMA 1999; 281: 172–179.

    Article  PubMed  CAS  Google Scholar 

  43. Doval H, Nul D, Grancelli H, et al., for the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA) Investigators. Randomized trial of low dose amiodarone in severe congestive heart failure. Lancet 1994; 344: 493–498.

    Article  PubMed  CAS  Google Scholar 

  44. a.Kadish A, Quigg R, Schaechter A, Anderson KP, Estes M, Levine J. Defibrillators in nonischemic cardiomyopathy treatment evaluation. PACE 2000; 23: 338–343.

    Article  Google Scholar 

  45. The CASS Investigators. Coronary Artery Surgery Study (CASS): A randomized trial of coronary artery bypass surgery survival data. Circulation 1983; 68: 939–950.

    Article  Google Scholar 

  46. Holmes DR, Davis KB, Mock MB, et al. The effect of medical and surgical treatment on subsequent sudden cardiac death in patients with coronary artery disease: a report from the coronary artery surgery study. Circulation 1986; 73: 1254–1263.

    Article  PubMed  Google Scholar 

  47. The CASCADE Investigators. Randomized Antiarrhythmic Drug Therapy in Survivors of Cardiac Arrest (the CASCADE Study). Am J Cardiol 1993; 72: 280–287.

    Article  Google Scholar 

  48. Haverkamp W, Martinez-Rubio A, Hief C, et al. Efficacy and safety of d,l-sotalol in patients with ventricular tachycardia and in survivors of cardiac arrest. J Am Coll Cardiol 1997; 30: 487–495.

    Article  PubMed  CAS  Google Scholar 

  49. Pacifico A, Hohnloser SH, Williams JH, et al. Prevention of implantable-defibrillator shocks by treatment with sotalol. d,l-sotalol implantable cardioverter-defibrillator study group. N Engl J Med 1999; 340 (24): 1855–1862.

    Article  PubMed  CAS  Google Scholar 

  50. Siebels J, Cappato R, Ruppel R, et al. for the Cardiac Arrest Study Hamburg (CASH) Investigators. Preliminary Results of the Cardiac Arrest Study Hamburg (CASH). Am J Cardiol 1993; 72: 109F–113F.

    Article  PubMed  CAS  Google Scholar 

  51. a.Huck K-H, Cappato R, Siebels J, Ruppel R, for the CASH investigators. Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: The Cardiac Arrest Study Hamburg (CASH). Circulation 2000; 102: 748–754.

    Article  Google Scholar 

  52. Connolly SJ, Gent M, Roberts RS, et al. Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 2000 Mar 21; 101 (11): 1297–1302.

    Article  CAS  Google Scholar 

  53. Fontaine G, Guiraudon G, Frank R, et al. Stimulation studies and epicardial mapping in ventricular tachycardia: study of mechanisms and selection for surgery. In: Kulbertus HE, ed. Reentrant Arrhythmias. MTP Publishers, Lancaster, 1977, pp. 334–350.

    Google Scholar 

  54. Marcus FI, Fontaine G. Arrhythmogenic right ventricular dysplasia. In: Podrid PJ, Kowey PR: Cardiac Arrhythmia: Mechanisms, Diagnosis, and Management. Williams and Wilkins, Baltimore, MD, 1995, pp. 1121–1130.

    Google Scholar 

  55. a.Ellison KE, Friedman PL, Ganz LI, Stevenson WG. Entrainment mapping and radiofrequency catheter ablation of ventricular tachycardia in right ventricular dysplasia. J Am Coll Cardiol 1998; 32: 724–728.

    Article  Google Scholar 

  56. Alfonso F, Frenneaux MP, McKenna WJ. Clinical sustained uniform ventricular tachycardia in hypertrophic cardiomyopathy: association with left ventricular apical aneurysm. Br Heart J 1989;61:178– 181.

    Google Scholar 

  57. Borggrefe M, Schwammenthal E, Block M et al. Pre-and Postoperative Electrophysiological Findings in Survivors of Cardiac Arrest and Hypertrophic Obstructive Cardiomyopathy Undergoing Myomectomy (abstract). Circulation 1993; 88 (Suppl): 1120.

    Google Scholar 

  58. McKenna WJ, Oakley CM, Krikler DM, et al. Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia. Br Heart J 1985; 53: 412–416.

    Article  PubMed  CAS  Google Scholar 

  59. a.Maron BJ, Shen WK, Link MS, et al. Efficacy of implantable cardioverter-defibrillators for the prevention of sudden death in patients with hypertrophic cardiomyopathy. N Engl J Med 2000 Feb 10; 342 (6): 365–373.

    Google Scholar 

  60. Valantine H, McKenna WJ, Nihoyannopoulos P, et al. Sarcoidosis, a pattern of clinical and morphological presentation. Br Heart J 1987; 57: 256–263.

    Article  PubMed  CAS  Google Scholar 

  61. Winters SL, Cohen M, Greenberg S, et al. Sustained ventricular tachycardia associated with sarcoidosis: assessment of the underlying cardiac anatomy and the prospective utility of programmed ventricular stimulation, drug therapy, and an implantable antitachycardia device. J Am Coll Cardiol 1991; 18: 937.

    Article  PubMed  CAS  Google Scholar 

  62. Sosa E, Scanavacca M, D’Avila A, et al. Endocardial and epicardial ablation guided by non-surgical transthoracic epicardial mapping to treat recurrent ventricular tachycardia. J Cardiovasc Electrophysiol 1998; 9 (3): 229–239.

    Article  PubMed  CAS  Google Scholar 

  63. Belhassen B, Rotmensch HH, Laniago S. Response of recurrent sustained ventricular tachycardia to verapamil. Br Heart J 1981; 46: 679–682.

    Article  PubMed  CAS  Google Scholar 

  64. Zipes DP, Foster PR, Troup PJ. Atrial induction of ventricular tachycardia: reentry versus triggered automaticity. Am J Cardiol 1978; 44: 1–8.

    Article  Google Scholar 

  65. Nakagawa H, Beckman KJ, McClelland JH, et al. Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a purkinje potential. Circulation 1993; 88: 2607–2617.

    Article  PubMed  CAS  Google Scholar 

  66. Gallarvardin Ll. Extrasystolie Ventriculaire a Paroxysmes Tachycardiques Prolonges. Arch Mal Coeur 1922; 15: 298.

    Google Scholar 

  67. Jackman W, Friday K, Anderson J, Aliot E, Clark M, Lazzara R. The Long QT Syndromes: A critical review, new clinical observations and a unifying hypothesis. Prog Cardiovasc Dis 1988;31:115– 172.

    Google Scholar 

  68. Napolitano C, Priori S, Schwartz P. Torsade de pointes: mechanisms and management. Drugs 1994; 47: 51–65.

    Article  PubMed  CAS  Google Scholar 

  69. Kay G, Plumb V, Arciniegas J, Henthorn R, Waldo A. Torsade de pointes: the long-short initiation sequence and other clinical features: observations in 32 patients. J Am Coll Cardiol 1983; 2: 806–817.

    Article  PubMed  CAS  Google Scholar 

  70. Keren A, Tzivoni D, Gavish D, Levi J, Gottlieb S, Benhorin J, et al. Etiology, warning signs and therapy of torsade de pointes. Circulation 1981; 64: 1167–1174.

    Article  PubMed  CAS  Google Scholar 

  71. Saxon L, Wiener I, Natterson P, Laks H, Drinkwater D, Stevenson W. Monomorphic versus polymorphic ventricular tachycardia after coronary artery bypass grafting. Am J Cardiol 1995; 75: 403–405.

    Article  PubMed  CAS  Google Scholar 

  72. Wolfe C, Nibley C, Bhandari A, Chatterjee K, Scheinman M. Polymorphous ventricular tachycardia associated with acute myocardial infarction. Circulation 1991; 84: 1543–1551.

    Article  PubMed  CAS  Google Scholar 

  73. Carter J, Childers R. Torsade de pointes complicating acute myocardial infarction. the importance of autonomic dysfunction as assessed by heart rate variability. Clin Cardiol 1992; 15: 769–772.

    Article  PubMed  Google Scholar 

  74. Eisenberg SJ, Scheinman MM, Dullet NK, et al. Sudden cardiac death and polymorphous ventricular tachycardia in patients with normal QT intervals and normal systolic cardiac function. Am J Cardiol 1995; 75: 687–692.

    Article  PubMed  CAS  Google Scholar 

  75. Dessertenne F. La Tachycardie Ventriculaire a Deux Foyers Opposes Variable. Arch Mal Coeur 1966; 59: 263–272.

    PubMed  CAS  Google Scholar 

  76. Dhurandhar RW, Macmillan RL, Brown KW. Primary ventricular fibrillation complicating acute myocardial infarction. Am J Cardiol 1990; 66: 1208–1211.

    Article  Google Scholar 

  77. a.Volpi A, Cavalli A, Santoro L, et al. Incidence and prognosis of early primary ventricular fibrillation in acute myocardial infarction—results of the gruppo italiano per lo studio della sopravvivenza nell’infarcto miocardico (GISSI-2) database. Am J Cardiol 1998; 82: 265–271.

    Article  Google Scholar 

  78. b.Kelly P, Ruskin J, Vlahakes GJ, Buckley MJ, Freeman CS, Garan H. Surgical coronary revascularization in survivors of prehospital cardiac arrest: its effect on inducible ventricular arrhythmias and longterm survival. J Am Coll Cardiol 1990; 15: 267–272.

    Article  Google Scholar 

  79. c.Natale A, Sra J, Axtell K, et al. Ventricular fibrillation and polymorphic ventricular tachycardia with critical coronary artery stenosis: does bypass surgery suffice? J Cardiovasc Electrophysiol 1994;5:988– 994.

    Google Scholar 

  80. d.Marcus FI. Idiopathic ventricular fibrillation. J Cardiovasc Electrophysiol 1997; 8: 1075–1083.

    Article  Google Scholar 

  81. Consensus statement. Survivors of out-of-hospital cardiac arrest with apparently normal heart. Circulation 1997; 95: 265–272.

    Article  Google Scholar 

  82. Belhassen B, Viskin S, Fish R, Glick A, Setbon I, Eldar M. Effects of electrophysiologic-guided therapy with Class IA antiarrhythmic drugs on the long-term outcome of patients with idiopathic ventricular fibrillation with or without the Brugada syndrome. J Cardiovasc Electrophysiol 1999; 10: 1301–1312.

    Article  PubMed  CAS  Google Scholar 

  83. g.Ruskin JN. Idiopathic ventricular fibrillation: is there a role for electrophysiologic-guided antiarrhythmic drug therapy? J Cardiovasc Electrophysiol 1999; 10: 1313–1315.

    Article  PubMed  CAS  Google Scholar 

  84. Antzelevitch C. The Brugada Syndrome. J Cardiovasc Electrophysiol 1998; 9: 513–516.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Reginald T. Ho MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Francis E. Marchlinski MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Leonard I. Ganz MD

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Ho, R.T., Marchlinski, F.E. (2002). Approach to the Patient with Ventricular Tachycardia or Ventricular Fibrillation. In: Ganz, L.I. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-090-2_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-090-2_12

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-218-6

  • Online ISBN: 978-1-59259-090-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation