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Treatment of Ventricular Arrhythmias—Suppression, Survival, and the Problem of Bias

BRIAN MCGOVERN, M.B.; HASAN GARAN, M.D.; and JEREMY N. RUSKIN, M.D.
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Massachusetts General Hospital; Boston, Massachusetts


Ann Intern Med. 1984;101(1):123-125. doi:10.7326/0003-4819-101-1-123
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Various innovative drug, surgical, and electrical treatments have been used recently for patients with ventricular tachyarrhythmias (1-8). Each approach has enthusiastic advocates who compare studies and attribute fewer recurrent arrhythmias or improved survival to a particular treatment. However, no adequate comparative studies between these therapies have been done. Furthermore, because of ethical and practical constraints, randomized placebo-controlled studies that may approximate an ideal comparison may never be done for some of these therapies (9). Because of reports of promising, albeit uncontrolled, data, many physicians are understandably reluctant to withhold a particular treatment from a patient considered to be at high

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