In the majority of patients with reduced LV function, temporary biventricular pacing improves CO and arterial blood pressure after surgery, especially when LV dilatation is present.

Ventricular tachyarrhythmias (VT) can cause sudden cardiac death. This can be prevented by an implantable cardioverter-defibrillator (ICD) but approximately 25% of patients with an ICD develop electrical storm (≥ 3 VTs within 24 hours) during the course of 4-5 years. This is a life-threatening event even in the presence of an ICD, particularly if incessant VT is present, and may significantly deteriorate the patient's psychological state if multiple shocks are discharged. Catheter ablation of VT has developed into a standard procedure in many specialized electrophysiology centers. Patients with hemodynamically stable and unstable VT are amendable to substrate-based ablation strategies. Catheter ablation can be performed as emergency procedure in patients with electrical storm as well as electively in patients with monomorphic VT stored in ICD memory. In patients with ischemic or non-ischemic cardiomyopathy, VT ablation is complementary to ICD implantation and can reduce the number of ventricular arrhythmia episodes and shocks and should be performed early. In patients with electrical storm, catheter ablation can acutely achieve rhythm stabilization and may improve prognosis in the long term. Further indications for catheter ablation exist in patients with idiopathic VT where catheter ablation represents a curative therapy, and in patients with symptomatic or asymptomatic frequent premature ventricular beats which may improve prognosis in patients with heart failure and cardiac resynchronization therapy.

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Arrhythmogenic syncopes can clinically resemble epileptic seizures ("convulsive syncope"). During basic work-up of syncope, the 12 lead ECG may provide valuable clues indicating an arrhythmogenic cause of syncope, showing excitation as well as repolarisation abnormalities. If an arrhythmogenic cause of syncope is suspected but ECG documentation as a proof of diagnosis is missing, implantation of an ILR can be useful. In LQTS, multiple gene mutations are known but cover only a fraction of clinical LQTS.