Malignant ventricular arrhythmias: nonpharmacological therapies

In these last few years the indications for non pharmacological options in the therapy of malignant ventricular arrhythmias have been extended. Some of these approaches (antiarrhythmic surgery, cardiac transplant, automatic implantable cardioverter defibrillator) have an exact clinical collocation, some others are still experimental. Our personal experience and the recent literature have been analysed to explain the state of the art of these therapies. We undoubtedly think that these options are a valid alternative to drugs in non responder patients. The choice needs an accurate evaluation. The clinical picture, not only arrhythmic, and the specific aim of each procedure should be carefully considered.