Fig. 12.1
A suggested algorithm/pathway for diagnosis and treatment of ES
12.4 Indication for Follow-Up and Referral
All patients who experienced an ES episode remain at high risk of recurrences even if effectively treated with catheter ablation and multiple antiarrhythmic drug prophylaxis. Often ES is the expression of worsening of the underling heart disease. For these reasons all patients who developed at least one episode of ES should be referred both to a heart failure specialist and proper electrophysiological management in order to optimize the heart failure therapy and evaluate indication to heart transplantation or left ventricular assistance devices both as a bridge to transplant and as destination therapy. Arrhythmic follow-up may be best done with home monitoring of the ICD that allows a prompt evaluation of arrhythmic events.
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