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February 5, 1982

Management of Ventricular Tachyarrhythmias: Part I

JAMA. 1982;247(5):671-674. doi:10.1001/jama.1982.03320300075034

VENTRICULAR tachyarrhythmias represent a substantial management problem in clinical practice, frequently posing a diagnostic and therapeutic dilemma in critical, often life-threatening circumstances. In this article, the current concepts and approaches to the management of ventricular arrhythmias will be addressed. Traditionally, ventricular arrhythmias are defined as abnormal impulses originating from areas below the division of the His bundle and may take the form of isolated ventricular premature beats (VPBs) or be more sustained. A ventricular rhythm lasting for three or more complexes with a rate of 100 to 250/min is called ventricular tachycardia (VT). Although hemodynamic deterioration frequently results, an organized and effective ventricular contraction pattern is usually maintained during VT unless the rates are exceedingly fast. When ventricular activation is rapid and chaotic, it is referred to as ventricular fibrillation (VF), the hemodynamic consequences of which are catastrophic, and is therefore considered to be the most malignant of all ventricular