The role of antiarrhythmic therapy in the management of nonsustained ventricular tachycardia

The incidence of nonsustained ventricular tachycardia (NSVT) after myocardial infarction (MI), has decreased significantly in the thrombolytic era and may not have a high enough power to predict sudden cardiac death or all-cause mortality post-MI. Nonetheless, noninvasive algorithms that utilize the combination of NSVT with left ventricular dysfunction, abnormal signal-averaged electrocardiogram, and heart rate variability can be used for better risk assessment. Recent multicenter studies have provided strong evidence for the use of an implantable cardioverter defibrillator in patients with NSVT and inducible sustained ventricual tachycardia. On the other hand anti-arrhythmic drugs have no role and most are harmful in asypmtomatic patients post-MI with NSVT.