Ventricular Arrhythmias

Implantable cardioverter defibrillators treat ventricular arrhythmias after they occur but do not prevent them. Beta-blockers are the only antiarrhythmic medication class proven to reduce mortality from ventricular arrhythmias in heart failure. Despite current therapy, arrhythmia and death rates in heart failure with reduced ejection fraction remain around 5–10% per year. Catheter ablation leaves up to one-third of patients with recurrent arrhythmias and has not demonstrated a mortality benefit in trials. Sudden cardiac death accounts for up to 20% of all deaths in the Western world. Patients with severe heart failure and recurrent ventricular arrhythmias have a poor prognosis, with mortality above 50% at 5 years.