Cardiac neuromodulation for ventricular arrhythmias: Current state and future perspectives. A comprehensive review

Electrical storm represents an urgent challenge in electrophysiology. Despite the use of antiarrhythmic medications and catheter ablation, refractory ventricular arrhythmias may persist, prompting the use of neuromodulation. This approach has evolved over the years, facing initial challenges owing to the intricacies of the autonomic nervous system. Animal studies have significantly enhanced our understanding of this system, paving the way for human studies on sympathetic modulation, which gained momentum in the early 2000s and expanded notably in cardiology in the 2010s. Presently, a variety of techniques coexist and offer diverse alternatives. Additionally, there are promising avenues for development that are primarily explored in animal models. This review aims to shed light on the diverse approaches currently available in this field.