Editorial: Heart Failure and Malignant Ventricular Arrhythmias

Abstract

Arrhythmic death is thought to be common in patients with heart failure because about half of those who succumb die suddenly and because ventricular arrhythmias are commonplace in patients with heart failure. Although this has never been convincingly proven it is likely to be true, because fortuitous ECG monitoring at the moment of death usually demonstrates a ventricular arrhythmia. It remains possible, however, that such arrhythmias are an epiphenomenon rather than a direct cause of death. Final proof of the causal role of ventricular arrhythmias in the death of heart failure patients requires definitive results of specific antiarrhythmic treatment in a large group of suitable patients. As yet no such evidence exists, but the results of many relevant trials involving antiarrhythmic drugs or implantable cardioverter/defibrillators are expected soon.