Sustained ventricular tachycardia associated with corrective valve surgery
Robert E Eckart1, Tomasz W Hruczkowski, Usha B Tedrow
1Brigham and Women's Hospital and Harvard Medical School, Boston, Mass, USA. robert.eckart@us.army.mil
Circulation
|October 10, 2007
Summary
Sustained ventricular tachycardia (VT) after valve surgery can occur early or years later, often due to scar-related reentry. Catheter ablation is effective in treating this condition.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Sustained monomorphic ventricular tachycardia (VT) post-cardiac valve surgery is not well-studied.
- Bundle-branch reentry is a known, but less common, cause.
Purpose of the Study:
- To investigate the causes and outcomes of VT after cardiac valve surgery.
- To evaluate the efficacy of catheter ablation for VT in this patient population.
Main Methods:
- Reviewed records of 496 patients undergoing electrophysiology study and VT ablation.
- Identified 20 patients with VT post-aortic or mitral valve surgery without myocardial infarction.
- Analyzed VT mechanisms, ablation success, and clinical outcomes.
Main Results:
- VT occurred early post-surgery or years later in 20 patients.
- Scar-related reentry (70%) was more common than bundle-branch reentry (10%).
- Catheter ablation abolished 98% of targeted VTs, with a 2.1-year follow-up showing 3 deaths.
Conclusions:
- VT after valve surgery presents bimodally: early or delayed.
- Scar-related reentry is the predominant mechanism in this patient group.
- Catheter ablation is a successful treatment option for post-valve surgery VT.
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