Flecainide in combination with a beta blocker can suppress ventricular ectopy by as much as 76% in patients with catecholaminergic poly- morphic ventricular tachycardia during exercise testing or clinical follow-up.S7.9.1.2-2,S7.9.1.2-6,S7.9.1.2-11 For refractory VA, verapamil or propafenone may also be effective.S7.9.1.2-9,S7.9.1.2-10,S7.9.1.2-12 ICD implantation in patients with catecholaminergic polymorphic ventricular tachycardia should be reserved for patients with prior SCA, or patients with refractory VAs on combination medical therapy. Inappropriate shocks are reported in 20% to 30% of catecholaminergic poly- morphic ventricular tachycardia patients with ICD programming in patients with catecholaminergic polymorphic ventricular tachycardia should be optimized to deliver therapy for VF and to minimize inappro- priate shocks and the risk of potentially fatal Left cardiac sympathetic denervation for catecholaminer- gic polymorphic ventricular tachycardia may reduce the frequency of recurrent ICD shocks although recurrent syncope, SCA, or SCD is reported in 9% to 32% of patients, with other minor complications in 20% to 70% of patients. It is best if the left cardiac sym- pathetic denervation is performed in centers with expertise in this procedure. Intensification of medical therapy or left cardiac sympathetic denervation is important in treating patients who present with recurrent appropriate ICD 3. Genetic testing may be useful to confirm the diagnosis of catecholaminergic polymorphic ventricular tachycardia, which is suggested by the development of bidirectional VT with exertion or stress. Recognition of catechol- aminergic polymorphic ventricular tachycardia as the cause for exertional symptoms should prompt aggressive therapy to prevent the sig- nificant risk of SCD. 