COR LOE Recommendations I C-LD In patients with life-threatening VT or VF associated with confirmed or clinically suspected myocarditis, referral to centers with mechanical hemodynamic support and advanced arrhythmia management is IIb C-LD In patients with giant cell myocarditis with VF or hemodynamically unstable VT treated according to GDMT, an ICD and/or an antiarrhythmic medication may be considered if meaningful survival of greater than 1 year Recommendation-Specific Supportive Text 1. Myocarditis is an inflammatory process often related to infection.S7.5-1,S7.5-5 S7.5-9 When patients are treated in centers with the availability of mechanical hemodynamic support proce- dures, cardiac catheterization, endomyocardial biopsy, advanced cardiac imaging procedures, and arrhythmia management including ICD implantation, outcomes appear improved.S7.5-1 The acute course of myocarditis varies ranging from an asymptomatic finding of transient ST-T changes noted on ECG to cardiogenic shock and recurrent VA.S7.5-10 S7.5-12 Acute management is largely supportive and can rapidly advance to requiring mechanical support.S7.5-13,S7.5-14 Cardiac arrhythmias range from conduction abnormali- ties to life-threatening VT and VF.S7.5-15 S7.5-17 Arrhythmias may require antiarrhythmic medi- cations and/or device therapy.S7.5-18 Giant cell myocarditis is fairly uncommon, but it is of particular importance because it typically affects young individuals and is usually fatal if VT may require antiar- rhythmic medications such as amiodarone and/ or an ICD that in some instances can be used as a bridge to more advanced HF therapies such as LVAD or transplant. Myocarditis and SCD have been reported with HIV infection.S7.5- Systemic lupus erythematous can cause myocarditis but only rarely VT or VF.S7.5-8,S7.5-22 In patients with Chagas disease, acute myocardi- tis is rare but more than one third of affected patients develop late myocardial damage with progressive HF. Conduction defects with pro- gression to complete heart block and VT or VF are common. 