Therapy of Acute myocarditis II:
Antiviral therapy (ribavirin) has not been proven effective. Interferon has resulted in the elimination of the viral genomes and improved left ventricular function in patients with chronic dilated cardiomyopathy and persistent viral genomes.
Immunosuppressive therapy has not proved useful in patients with acute myocarditis and reduced LV function.
However, immunosuppression with steroids and azathioprine for 3–6 months has been found effective in patients with chronic dilated cardiomyopathy, and biopsy-proven virus-negative myocarditis.
Intravenous immune globulin did not improve LV function. However, in children with acute myocarditis, high-dose gamma-globulin (2 g/kg over 24 hours) resulted in improvement of LV function and a tendency to better survival in the first year after treatment.
ICD implantation is indicated in patients with giant cell myocarditis, regardless of LVEF.