title: Ventricular arrhythmias and sudden cardiac death.
abstract: Management strategies for ventricular arrhythmias are guided by the risk of sudden death and severity of symptoms. Patients with a substantial risk of sudden death usually need an implantable cardioverter defibrillator (ICD). Although ICDs effectively end most episodes of ventricular tachycardia or ventricular fibrillation and decrease mortality in specific populations of patients, they have inherent risks and limitations. Generally, antiarrhythmic drugs do not provide sufficient protection from sudden death, but do have a role in reducing arrhythmias that cause symptoms. Catheter ablation is likewise important for reducing the frequency of spontaneous arrhythmias and is curative for some patients, usually those with idiopathic arrhythmias and no heart disease. Arrhythmia surgery is now infrequent, offered by only a few specialised centres for refractory arrhythmias. Advances in understanding of genetic arrhythmia syndromes and in technology for mapping and ablation of ventricular arrhythmias, and enhanced algorithms in implantable devices for rhythm management, have contributed to improved outcomes.
authors.affiliation: Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. rjohn2@partners.org
authors.forename: Roy M
authors.initials: RM
authors.lastname: John
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Koplan
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Epstein
authors.forename: Michael O
authors.initials: MO
authors.lastname: Sweeney
authors.forename: Amy Leigh
authors.initials: AL
authors.lastname: Miller
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
mesh_terms: D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D053840:Brugada Syndrome / Q000503:physiopathology / Q000628:therapy; D016887:Cardiopulmonary Resuscitation; D017115:Catheter Ablation; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D006801:Humans; D008133:Long QT Syndrome / Q000503:physiopathology / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000150:complications / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D014693:Ventricular Fibrillation / Q000150:complications / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*