Long-term results of surgery for non-ischemic ventricular tachycardia.
Drug resistant, non-ischemic ventricular tachycardia (VT) was treated in 43 patients by direct surgery based on electrophysiological data. Two main surgical techniques were employed: myocardium was resected followed by cryocoagulation with a special probe in 23 patients with VT originating from the right ventricle. The myocardium was incised followed by cryocoagulation in 10 patients with VT from the left ventricle. The follow-up period ranged from 1 week to 10 years, 4 weeks (mean 3 years, 8 months). After operation, 36 patients (83%) showed complete disappearance of VT without antiarrhythmic therapy. Of these 2 patients died of congestive heart failure not related to VT in the postoperative period at 1 year 4 months, and 2 years 4 months, respectively. In 7 patients, VT remained. In 2, VT disappeared after catheter ablation. In 3 patients, VT became controllable with antiarrhythmic therapy. Operation was not successful in 2 patients (5%); 1 with a giant left ventricular aneurysm died of low cardiac output syndrome due to VT 1 week after operation; the other with arrhythmogenic right ventricular dysplasia originating from both ventricles died suddenly 5 months after operation. The 10-year survival is 89%, and the 10-year freedom from recurrent VT is 83%. These results indicate that surgical management for non-ischemic VT is safe and effective with a high chance of cure.
Iwa
T
T
Department of Surgery I, Kanazawa University School of Medicine, Japan.
Misaki
T
T
Kawasuji
M
M
Matsunaga
Y
Y
Tsubota
M
M
Matsumoto
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002304:Cardiac Pacing, Artificial; D002648:Child; D003452:Cryosurgery / Q000295:instrumentation; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D013610:Tachycardia / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014672:Vectorcardiography / Q000295:instrumentation