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Beta-blocker therapy has been shown to be beneficial
in patients after myocardial infarction reducing cardiovascular mortality, morbidity and
sudden death (see Yusuf et al, 1985). The benefit of beta-blocker therapy to decrease
sudden death in patients after myocardial infarction is especially evident in subgroups
with a history of congestive heart failure and in patients with both congestive heart
failure and frequent ventricular arrhythmias (Yusuf et al, 1985; Chadda et al, 1986;
Lichstein et al, 1990; Viscoli et al, 1993). The mechanisms by which the reduction of
sudden death due to beta-blockers are brought about, may be anti-ischaemic, antiectopic or
antifibrillatory. Because of these favourable effects of beta-blockers for primary
prevention of life-threatening sustained ventricular tachyarrhythmias in post-myo-cardial
infarction patients and because of harmful effects of Class I antiarrhythmic agents
reported recently in the same patient population (CAST, 1989), treatment of patients with
a history of sustained ventricular tachyarrhythmias with beta-blockers has gained much
interest in the last years.
This survey reviews our current knowledge about the efficacy of beta-blocker therapy
in patients with sustained ventricular tachycardia, and in patients after cardiac arrest,
as assessed either by uncontrolled clinical observation (chapter I) or controlled
prospective trials (chapter II).
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