Excisional surgery for patients with ventricular tachyarrhythmias.
Thirty-eight patients with drug refractory ventricular tachycardia have been operated on since 1980. An attempt at preoperative localization of the site of arrhythmia was made in those patients who did not have severe ischemia or multifocal tachycardia. Operation consisted of intraoperative mapping, when feasible, subendocardial resection and cryolesions placed when sites of interest could not be resected. Patients averaged 56 +/- 44 years of age and 25 had associated coronary bypass. The operative mortality was 5/38 (13%) and two deaths were related to recurrent arrhythmia. Of 33 survivors, 21 (64%) were cured of their arrhythmia and an additional nine patients who had been drug refractory were controlled with medication alone. The best results were found in patients with anteroapical scar and unifocal tachycardia. Thus, direct operation for drug refractory ventricular tachycardia can be performed at a reasonable risk and with a high likelihood of successful arrhythmia control.
Hammon
J W
JW
Vanderbilt University Medical Center, Department of Cardiac and Thoracic Surgery, Nashville, Tennessee.
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002303:Cardiac Output, Low / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D002921:Cicatrix / Q000601:surgery; D003327:Coronary Disease / Q000601:surgery; D003452:Cryosurgery; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D012008:Recurrence; D013610:Tachycardia / Q000503:physiopathology / Q000601:surgery*; D000267:Tissue Adhesions / Q000601:surgery
D000889:Anti-Arrhythmia Agents