Evaluation and Management of Ventricular Arrjuthmias [Ref]

Arrhythmia Present

No Therapy

-Blockers

EPS ?

AA Drugs

-Blockers

EPS ?

AA Drugs

EPS

ICD

Reversible Cause

Correct problem

ICD

RFCA

-Blockers

Verapamil

EPS?

AA Drugs

ICD

ICD

EPS

Amiodarone or Sotalol

EPS Guided

ICD

Ventricular Arrhythmia

Atrial (Supraventricular) Arrhythmia

PVC

VT-NS

VT-S

Cardiac Arrest

No Symptoms

Palpitations

Low Risk

High Risk

Healthy Heart

Cardomyopathy

Coronary Artery Disease

VT-NS

VT-S

Yes

No

LVEF >35%

LVEF <35%

Syncope of Presyncope

VT-S

No VT-S

Ref: Cannom DS and Prystowsky EN. 1999 JAMA 281(2):173

EPS = Electrophysiology Study

AA = Anti-Arrhythmic

VT-NS = nonsustained VTach

VT-S = sustained VTach

END