Pathophysiology of ventricular tachyarrhythmias amenable to electric control

Technical advances now permit permanent implantation of devices such as antitachycardia pacemakers, cardioverters and cardioverter-defibrillators for control of ventricular tachyarrhythmias. Despite the fact that these devices have been implanted only in patients resistant to conventional medical and surgical management, their effectiveness has been very encouraging. While improved designs are anticipated, preliminary studies have clearly indicated that one of the major challenges for successful clinical use will be appropriate interfacing of the device with the pathophysiology of the patient. Failure to recognize this fact will likely lead to unsuccessful clinical application. Moreover, these new instruments appear to be complementary to, rather than a replacement for, existing medical and surgical approaches to the patient with life-threatening ventricular tachyarrhythmias.