[Surgical treatment of ventricular tachycardia in patients with arrhythmogenic right ventricular dysplasia and their long follow-up results].
We have treated surgically the drug-refractory ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular dysplasia. The early and late results of the cryoablation were studied. We operated 8 patients. They showed 10 clinical VTs. A total of 21 VTs were detected (17 VTs during preoperative EPS, 4 VTs during intraoperative EPS). 19 VTs were operated: the origins of 15 VTs were determined by the intraoperative mapping, while those of 4 VTs were suspected by the preoperative EPS. During the follow-up time (mean 3.25 +/- 1.46 years), no patient died, VTs recurred in 2 patients and a new VT was seen in one patient. No recurrence was recognized in 12 VTs operated with the cryoablation applied from the endocardial side, but 4 out of 7 VTs recurred which were operated from the epicardial side. Cardiac arrest induced by aortic clamping didn't affected the efficacy of the cryoablation in the case of epicardial approach. CTR increased slightly postoperatively, from 49.9 +/- 4.4% to 53.3 +/- 5.3% at the 29.2 +/- 15.9 pom. No patients showed the signs of congestive heart failure postoperatively and required the medication except the patients with VT recurrence and a patient with the atrial flutter-fibrillation. In conclusion, even though this disease has the difficulty in the eradication of arrhythmia, VTs actually threatening the patient life at present could be cured by the cryoablation from the endocardial side.
Isobe
F
F
Division of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
D003452:Cryosurgery; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D013610:Tachycardia / Q000473:pathology / Q000601:surgery*