Paroxysmal rapid heart action is generally treated successfully by the application of vagal stimulation or by the use of drugs. The 3 most effective drugs are quinidine, procaine amide, and the digitalis glycosides. A small group of life-threatening atrial or ventricular arrhythmias exist, however, which have proved refractory to all forms of therapy.
A report in this issue of The Journal (page 916) describes a promising new approach in dealing with such an arrhythmia, in this case ventricular tachycardia, which had proved resistant to the usual measures. Two discrete episodes, occurring in the same patient, were promptly terminated by external electric countershock. Light anesthesia was administered briefly during the delivery of the countershock. The first bout of tachycardia was treated initially with large doses of procaine amide and quinidine. During the second episode, only small doses of antiarrhythmic drugs were employed. It is of interest that with restoration of sinus
ELECTRIC COUNTERSHOCK AND VENTRICULAR TACHYCARDIA. JAMA. 1961;177(13):914. doi:10.1001/jama.1961.03040390028010