Approach to antiarrhythmic therapy in patients with ICDs and frequent activations.

Patients with an implantable defibrillator may require concomitant antiarrhythmic drug therapy to reduce therapy from the device, especially shocks from the device. New evidence suggests that amiodarone, in combination with b-blockade, is the most effective treatment to reduce the frequency of defibrillator therapies, but sotalol and azimilide have also been shown to be effective. Electrical storm is a serious condition that occurs in 20% of patients living with a defibrillator, and its management requires a complex approach to the patient.