Arrhythmia in Patients with a Cardiomyopathy and Congestive Heart Failure

Abstract

Many advances in the treatment of congestive heart failure (CHF) have resulted in improved survival, and a growing number of such patients are being seen by physicians. Although several interventions have reduced the number of patients dying from progressive CHF, sudden cardiac death remains a frequent and important problem in this patient population. It is now well established that ventricular premature beats (VPBs) and complex ventricular arrhythmia, particularly nonsustained ventricular tachycardia (VT), are commonly observed in these patients. It has been proposed that spontaneous ventricular arrhythmia, which results from underlying electrical instability of the myocardium, is a marker of an abnormal substrate capable of generating and sustaining arrhythmia. Additionally, spontaneous arrhythmia may serve as a trigger activating the mechanisms responsible for a sustained ventricular tachyarrhythmia.