Management of ventricular arrhythmias in structural heart disease

Postgrad Med. 2015 Jun;127(5):549-59. doi: 10.1080/00325481.2015.1045816. Epub 2015 May 13.


Ventricular arrhythmias (VA) are a source of significant morbidity and mortality in patients with structural heart disease (SHD). The advent of the implantable cardiac defibrillator (ICD) has had a positive effect on mortality, but the associated morbidity remains a significant problem. Modern treatment of VA has advanced far beyond medical therapy and includes strategies as simple as intelligent ICD programming and as complex as catheter ablation (CA). In these pages, the spectrum of management strategies will be discussed; from anti-arrhythmic drugs and ICD implantation and programming to CA and autonomic modulation. The focus of this review will be on strategies for secondary prevention of VA in patients with SHD, supported by clinical evidence for their utilization.

Keywords: Ventricular tachycardia; ablation; cardiomyopathy; implantable defibrillator; sympathetic denervation; ventricular fibrillation.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use
  • Cardiac Resynchronization Therapy
  • Cardiomyopathies / complications*
  • Cardiomyopathies / pathology
  • Cardiomyopathies / physiopathology
  • Catheter Ablation
  • Defibrillators, Implantable
  • Humans
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / therapy*
  • Ventricular Flutter / diagnosis
  • Ventricular Flutter / etiology
  • Ventricular Flutter / therapy*


  • Anti-Arrhythmia Agents