Beyond the implantable cardioverter-defibrillator: are we making progress?

Sudden cardiac death due to ventricular fibrillation occurs when a dynamic interaction between triggers and substrate leads to the development of reentry, initiation of ventricular tachycardia, and its degeneration to fibrillation. To move beyond the implantable cardioverter-defibrillator as the only effective therapy for aborting sudden cardiac death, an improved understanding of trigger-substrate interaction is essential. This brief review summarizes some of the recent progress in this direction.