This review outlines the spectrum of management strategies for secondary prevention of ventricular arrhythmias in patients with structural heart disease, ranging from medical therapy and ICD programming to catheter ablation and autonomic modulation.
Provides overview of VA secondary prevention options in structural heart disease; leaves open optimal strategy selection pending comparative trials.
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.
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Jacobson et al. (2015) studied this question.
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