Mechanisms and management of ventricular dysrhythmias in heart failure

Despite recent pharmacologic and surgical advances in the management of heart failure, the morbidity and mortality rates of this chronic illness remain high. Ventricular dysrhythmias are common in heart failure and may be independently associated with increased mortality rates. Although the risks of sudden cardiac death leading to the patient's death are increased by the presence of complex ventricular dysrhythmias, the management of dysrhythmias is subject to controversy. The purpose of this article is to review the normal electrophysiologic properties of the heart and to examine the likely mechanisms, diagnostic approaches, and proposed treatments for ventricular dysrhythmias in heart failure.