Psychiatric treatment strategies for patients at risk of dying suddenly

This paper outlines the development of psychiatric treatment approaches to certain patients with life-threatening ventricular arrhythmias which may affect outcome, both psychological and, at times, medical. Three cases sketches which illustrate psychiatric management strategies are presented. One case history indicates how lack of adherence to such treatment contributed to a negative outcome. Emphasis is placed on an integrated approach to psychiatric treatment which is individualized for each patient. The importance of close liaison with cardiologist, selective psychotherapy, stress management skills and family involvement is highlighted.