Surgery for ventricular tachycardia and left ventricular aneurysm provides arrhythmia control.
OBJECTIVE
Report long-term freedom from ventricular tachycardia (VT), survival, and causes of death in patients with left ventricular aneurysm and VT, who underwent a combined procedure for VT and surgical ventricular restoration (SVR).


METHODS
The primary outcome measures VT, survival, and cause of death, were ascertained by review of patients' records, interrogation of implanted cardioverter-defibrillators and use of national registers.


RESULTS
Mean follow-up was 5.2 years. Overall survival was 62% at 5 years and 51% at 9 years. Freedom from spontaneous VT was 89%. In 32 patients who were non-inducible at postoperative testing, there was no occurrence of VT during a mean follow-up of 6.0 years. Causes of death were cardiac in 17 patients, and non-cardiac in 6 patients. No patient died from ventricular arrhythmia.


CONCLUSIONS
Direct surgery for VT combined with SVR resulted in a very low risk of late recurrence of VT and good long-term survival. Implantation of a cardioverter-defibrillator can safely be withheld in patients who are non-inducible on postoperative programmed electrical stimulation.
Sartipy
Ulrik
U
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden. ulrik.sartipy@karolinska.se
Löfving
Anders
A
Albåge
Anders
A
Lindblom
Dan
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006322:Heart Aneurysm / Q000401:mortality / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome