[Life-threatening ventricular tachyarrhythmia after CABG in a patient with poor LV function--an experience with the implantable cardioverter defibrillator].
A 52-year-old man with reduced left ventricular function (ejection fraction 0.27) due to myocardial infarction, underwent coronary artery bypass grafting (CABG; LITA-LAD, free RITA-4PD) for angina pectoris. He had suffered from recurrent sustained ventricular tachycardia (VT) since 5 hours after CABG. This arrhythmia was resistant to various antiarrhythmic agents such as Lidocaine, Mexiletine, Disopyramide, Procainamide and Propafenone. He required mechanical circulatory supports (intra-aortic balloon pumping and percutaneous cardiopulmonary support) for the maintenance of hemodynamics during repeated VT that required cardioversions of a total of 441 times during 18 days. Following the administration of Amiodarone, the VT was successfully suppressed. However, he had repeated episodes of VT on exercise, thus, he underwent insertion of the implantable cardioverter-defibrillator at the 98 post-operative day, and he was successfully discharged at the 134 post-operative day after CABG. The instrument was verified to be normal in function after the VT induction test.
Yoshikawa
Y
Y
Department of Surgery III, Nara Medical College, Japan.
Taniguchi
S
S
Kawata
T
T
Hamada
Y
Y
Kawachi
K
K
Kitamura
S
S
D001026:Coronary Artery Bypass; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000628:therapy*; D018487:Ventricular Dysfunction, Left / Q000601:surgery*