Non-medical therapy of ventricular tachyarrhythmias

In recent years, development of non-pharmacological therapy has provided new therapeutic possibilities for patients with ventricular tachyarrhythmias. One of the major advances is the automatic cardioverter-defibrillator which has reduced dramatically the number of arrhythmic deaths in patients with ventricular tachycardia or fibrillation. Surgery of ventricular arrhythmias represents an interesting alternative in selected patients as it provides a cure. Electrical ablation of the arrhythmogenic substrates is still experimental. The mortality associated with the procedure in patients with coronary artery disease represents a serious limitation. A careful selection of the indications in order to tailor therapy to the patient is needed and guidelines are proposed.