Few scenarios in intensive coronary care are commonly associated with as much fear and apprehension as the event of a ventricular tachyarrhythmia. This chapter provides information to help successfully manage such situations. Residents, fellows, and physicians involved in providing acute cardiac care are in need of broad background knowledge regarding the diagnostic and therapeutic means, as well as the prognostic implications of such events, in order to provide adequate medical care to their patients. The present chapter summarizes information on the pathophysiological basis of ventricular tachyarrhythmias and teaches tools to detect and correctly differentiate a ventricular from a supraventricular arrhythmia on the surface electrocardiogram. The chapter provides the reader with a summary of specific treatment modalities and information on indications for treatment with an implantable cardioverter-defibrillator. Last, the chapter deals with the management of device interventions (appropriately delivered for ventricular tachyarrhythmias or inappropriately delivered for other reasons) within the increasing population of patients fitted with an implantable cardioverter-defibrillator.