title: Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?
abstract: Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia.
authors: Electrophysiology Section, Division of Cardiology, Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA; VCU Pauley Heart Center, Medical College of Virginia, Virginia Commonwealth University School of Medicine, 1250 E Marshall Street, Richmond, VA 23298, USA. Electronic address: alex.tan@va.gov.
authors: Alex Y
authors: AY
authors: Tan
authors: VCU Pauley Heart Center, Medical College of Virginia, Virginia Commonwealth University School of Medicine, 1250 E Marshall Street, Richmond, VA 23298, USA.
authors: Kenneth
authors: K
authors: Ellenbogen
mesh_terms: D017147:Defibrillators, Implantable; D006801:Humans; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery; D018879:Ventricular Premature Complexes
keywords: Implantable cardiac defibrillator; Premature ventricular complex; Sudden cardiac arrest; Ventricular arrhythmia