Most studies evaluating the benefits of CABG in patients with ventricular arrhythmias have examined survivors of out-of-hospital cardiac arrest as well as patients with induc- ible ventricular tachycardia or fibrillation during electro- physiological study.272 274 In general, CABG has been more effective in reducing the occurrence of ventricular fibrillation than of ventricular tachycardia, because the mechanism of the latter is usually reentry with scarred endocardium rather than ischemia. Observational studies have demonstrated a favor- able prognosis of subjects undergoing CABG for ischemic In survivors of cardiac arrest who have severe but operable CAD, CABG can suppress the appearance of arrhythmias, reduce subsequent episodes of cardiac arrest, and result in a good long-term outcome.271 273 It is particularly effective when an ischemic cause of the arrhythmia can be documented (for instance, when it occurs with exercise).275 Still, because CABG may not alleviate all the factors that predispose to ventricular arrhythmias, concomitant insertion of an implant- able cardioverter-defibrillator is often warranted.276 Simi- larly, continued inducibility or clinical recurrence of ventric- ular tachycardia after CABG usually requires an implantable cardioverter-defibrillator implantation. Patients with depressed LV systolic function, advanced age, female sex, and increased CPB time are at higher risk for life-threatening arrhythmias in the early postoperative period. Given the poor short-term prognosis of those with these arrhythmias, mechanical and ischemic causes should be considered in the postoperative setting.277 279 2.2.3. Emergency CABG After Failed PCI: Recommendations Class I 1. Emergency CABG is recommended after failed PCI in the presence of ongoing ischemia or threatened occlusion with substantial myocardium at risk.280,281 (Level of Evidence: B) 2. Emergency CABG is recommended after failed PCI for hemodynamic compromise in patients without impairment of the coagulation system and without a previous sternotomy.280,282,283 (Level of Evidence: B) Class IIa 1. 