Nonpharmacologic treatment of life-threatening cardiac arrhythmias

Numerous nonpharmacologic modalities have been introduced for the management of patients with life-threatening arrhythmias. These include cardiac pacing, insertion of an automatic internal cardiac defibrillator (AICD), cardiac electrosurgery, and catheter ablative techniques. Each modality is effective; AICD shows particular promise because it has demonstrated remarkable efficacy in decreasing the incidence of sudden cardiac death in patients with malignant ventricular arrhythmias. Each modality also has its limitations or contraindications. Nonpharmacologic antiarrhythmic therapy represents an important advance against the serious public health problem of sudden cardiac death.