Economic aspects of treatment with captopril after MI.

associated with increased mortality in the setting of incessant tachycardia'. This was also the experience of more recent investigators using surgery. Other investigational approaches never fulfilled their initial promise'". Therefore, the work of Cao and Gonska is very important. It confirms earlier reports on sustained ventricular tachycardia, and proves not only that it is possible to localize the area of slow conduction and interrupt re-entry in patients with ischaemic heart disease (and possibly with large aneurysms), but also that this can be achieved very successfully in critically ill patients; the complication rate is surprisingly low. The fact that there are recurrences of tachycardia during the follow-up is no surprise, but as implantable cardioverters/ defibrillators are available these situations can be managed. These results are so encouraging that a more aggressive approach may be possible — also as regards paroxysmal sustained tachycardia — before proceeding to the implantation of devices. Briefly, the paper by Cao and Gonska is the herald of more work in the cath lab in the foreseeable future.