Deutsche medizinische Wochenschrift
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The assessment of the QT interval has been an integral part of ECG interpretation since the first descriptions of long QT syndrome by Wolff in 1950 and by Jervell and Lange-Nielsen in 1957. The correct measurement of the QT interval as well as a correct interpretation of the causes and of the clinical consequences of a QT prolongation, however, may be difficult even for trained internists and cardiologists. In this review, we give an overview on physiological determinants of cardiac repolarization, its marker in the surface ECG - the QT interval -, methods to correctly assess QT interval duration, causes for pathologically prolonged QT intervals, and resulting clinical consequences. ⋯ The therapeutic approaches for LQTS are multimodal. Prevention is the basis of the therapy and includes avoiding known risk factors / and potentially QT-prolonging drugs, and a pharmacological treatment with non-selective beta blockers. According to the risk profile and to the patient's lifestyle the implantation of an ICD or a pacemaker should be considered.
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Dtsch. Med. Wochenschr. · Apr 2020
Review[Is There Still a Need for Medical Antiarrhythmic Therapy?]
The use of medical antiarrhythmic therapy apart from beta-blockers has been steadily decreasing in the recent past. This can partly be attributed to technological progress that has rendered the ablation of complex cardiac arrhythmias like atrial fibrillation, focal atrial tachycardias and ventricular arrhythmias feasible and efficacious. ⋯ Nevertheless, medical antiarrhythmic therapy still plays a fundamental role in acute therapy of arrythmias as well as certain indications for long-term therapy. This review comprehensively summarizes the current role of medical antiarrhythmic therapy in daily clinical practice focusing on mechanisms and therapies of the most common cardiac arrythmias.