Ventricular arrhythmias

Ventricular arrhythmias are abnormal rhythms that originate from below the atrioventricular node. They include premature ventricular complexes, ventricular tachycardias, and ventricular fibrillation. Ventricular arrhythmias may occur in patients with structural heart disease (ischaemic heart disease, cardiomyopathies such as dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, etc.) or in patients with a structurally normal heart (genetic arrhythmia syndromes such as long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, or as idiopathic ventricular tachycardias). Symptoms depend on the frequency, duration, and haemodynamic effects of the arrhythmia. They may be asymptomatic or may cause symptoms, such as palpitations, shortness of breath, chest discomfort, dizziness, or syncope, or may present with cardiac arrest. This chapter is focused on the role of antiarrhythmic drugs in the management of ventricular arrhythmias. The recommendations are based on the current guidelines of the European Society of Cardiology for the management of patients with ventricular arrhythmias.