[Encircling endocardial ventriculotomy in the treatment of recurrent ventricular tachycardia after myocardial infarction].
Thirty nine men and two women aged 26 to 76 years old (average 55 years) with ventricular tachycardia (VT) complicating chronic myocardial infarction were operated on between December 1971 and September 1980. Epicardial mapping was performed in sinus rhythm in 25 cases and in VT in 12 cases. The series was divided into two consecutive groups: --The first group comprised 14 patients operated on between December 1971 and November 1975 in which the operative mortality at the 30th day was 36%. There was one death due to recurrent VT in the early post-operative period; two deaths due to arrhythmia were observed between the 11th and 26th postoperative months. VT was successfully prevented in 6 cases with over 2 years' follow-up. --The second group comprised 27 patients operated after November 1975, in which encircling endocardial ventriculotomy (EEV) was the procedure used. The operative mortality fell to 18% with no relation to the arrhythmia. In the first 10 cases of this group, VT recurred in 2 patients in the early postoperative period. These two cases were controlled with antiarrhythmic therapy at doses that had been ineffective preoperatively. Four other recurrences of VT were observed at the 3rd, 34th, 45th, and 56th postoperative months. They were controlled by anti arrhythmic agents in 3 cases. The other patient died. VT was prevented for over 2 years in 7 patients and for over I year in 16 patients. These results suggest that EEV is more effective than the techniques used previously in resistant VT. Its side effects on myocardial contractility are discussed.
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D004594:Electrophysiology; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011379:Prognosis; D012008:Recurrence; D013610:Tachycardia / Q000209:etiology / Q000601:surgery*
D000889:Anti-Arrhythmia Agents
Apports de la ventriculotomie circulaire d'exclusion dans le traitement de la tachycardie ventriculaire récidivante après infarctus du myocarde.