Ventricular tachycardia surgery in 1992: did the automatic defibrillator change this approach?
The role of ventricular tachycardia (VT) surgery has been changed since the automatic implantable cardioverter defibrillator (ICD) is available. We studied the follow-up of 131 patients who underwent mapping guided surgery due to recurrent VT refractory to antiarrhythmic drug treatment. There were 65 patients operated upon between 1980-1985 (group I) and 66 patients between 1986-1991 (group II). Ten patients (8%) died perioperatively (< 3 weeks after surgery) [7/65 patients, 11%, in group I and 3/66 patients, 5%, in group II (P = 0.15)]. During a mean follow-up of 41 +/- 24 months, 38 of 121 patients died (31%), significantly more patients in group I (24/58 patients, 41%) than in group II (14/63 patients, 22%) (P < 0.05). In group I, there was a higher incidence of sudden (7/58 patients, 12%) or cardiac death (15/58 patients, 26%) than in group II (sudden death 4/63 patients, 6%, cardiac death 7/63 patients, 11%) (P < 0.05). There was a similar incidence of VT recurrences between group I (9/65 patients, 14%) and group II (9/66 patients, 14%). Our data show that the indication for VT surgery has changed since the ICD is available because of better patient selection.
Trappe
H J
HJ
Department of Cardiology, University Hospital Hannover, Germany.
Klein
H
H
Wenzlaff
P
P
Frank
G
G
Siclari
F
F
Götte
A
A
Lichtlen
P R
PR
D006328:Cardiac Catheterization; D002304:Cardiac Pacing, Artificial; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome