[Long-term follow-up of anti-tachycardia surgery in patients with ventricular tachycardia].
From March 1980 to May 1992 mapping guided surgery was performed in 132 patients with drug-refractory recurrent ventricular tachycardia. There were 121 patients (group I) with coronary disease and 11 patients (group II) had noncoronary ventricular tachycardia. Patients in group I underwent subendocardial resection and cryoablation was performed in group II patients. Perioperative mortality (< 30 days after surgery) was 8% (10/132 patients). During the mean follow-up of 41 +/- 24 months, 37/122 patients (30%) died, 35/111 patients in group I (32%) and 2/11 patients in group II (18%) (p = 0.29). In group I, sudden death occurred in 8/111 patients (7%) and cardiac death in 23/111 patients (21%); in group II, 1/11 patients (9%) died from sudden and 1/11 patients (9%) from cardiac death. Nonfatal recurrences occurred significantly more frequently in group II (6/11 patients, 55%) than in group I (16/111 patients, 14%) (p < 0.01). During the follow-up functional class of heart failure improved in 69 patients (57%), remained constant in 27 patients (22%) and decreased in the remaining 26 patients (21%). The surgical approach to control ventricular tachycardia has low rates of sudden death and nonfatal recurrences in patients with drug-refractory ischemic ventricular tachycardia. Patients with noncoronary disease had a high incidence of nonfatal ventricular tachycardia after surgery and should be considered for other therapeutic approaches in the future.
Trappe
H J
HJ
Abteilung Kardiologie, Medizinische Hochschule Hannover.
Klein
H
H
Wenzlaff
P
P
Frank
G
G
Siclari
F
F
Fieguth
H G
HG
Wahlers
T
T
Lichtlen
P R
PR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002036:Bundle of His / Q000503:physiopathology; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery; D003452:Cryosurgery; D004562:Electrocardiography; D004699:Endocardium / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*