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Clinical and electrophysiologic findings following operative therapy of ventricular tachycardias

Clinical and electrophysiologic findings following operative therapy of ventricular tachycardias

Zeitschrift für Kardiologie 73(4): 206-213

40 patients with sustained ventricular tachycardia underwent either complete (n = 12) or partial (n = 28) endomyocardial encircling ventriculotomy ( EEV ). All patients had coronary artery disease, mean age 54 years. Aneurysmectomy was performed in 35 patients. 30 patients also received coronary artery bypass grafts. There were 3 perioperative deaths (7.5%): 1/12 with complete and 2/28 with partial EEV . All survivors underwent programmed right ventricular stimulation postoperatively. Ventricular tachycardia was not inducible in 23 of 36 patients (64%). One patient was not studied postoperatively. In contrast, sustained ventricular tachycardia was still inducible in 13 patients. Ventricular tachycardia was considered as "clinical" tachycardia in 9 patients whereas it was a "non-clinical" form in another 4 patients. Thus the electrophysiological failure rate with regard to "clinical" forms was 25%. In 2 of 4 patients with spontaneous recurrences during the first postoperative week, sustained ventricular tachycardia could not be induced during the postoperative electrophysiological study. During follow-up (mean 18 months), spontaneous recurrence of ventricular tachycardia occurred in 2 patients. Cardiac arrest possibly due to coronary bypass occlusion occurred in 1 patient who could be resuscitated. 6 patients died late postoperatively: 4 of congestive heart failure, 1 of re-infarction and 1 of fulminant pneumonia. 3/11 patients (27.3%) with complete and 1/26 (3.8%) with partial EEV died because of congestive heart failure (p less than .03). Thus abolition of spontaneous sustained ventricular tachycardia was successfully achieved in 94.6% of cases surviving surgery (91.9% if the patient with cardiac arrest is included.

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Accession: 042552743

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PMID: 6730623

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