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Low-risk profile for malignant ventricular arrhythmias and sudden cardiac death after surgical ventricular

Massimo Baravelli1, Paolo Cattaneo, Andrea Rossi

  • 1Department of Cardiology and Intensive Cardiac Rehabilitation, Multimedica Holding, Castellanza, Varese, Italy. massimo.baravelli@virgilio.it

Pacing and Clinical Electrophysiology : PACE
|May 22, 2010
PubMed

Insights

Surgical ventricular reconstruction (SVR) added to coronary artery bypass grafting (CABG) shows a low incidence of sudden cardiac death and ventricular arrhythmias. Preoperative left ventricular end-systolic volume index and postoperative pulmonary artery systolic pressure predict these arrhythmic events.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Surgical ventricular reconstruction (SVR) combined with coronary artery bypass grafting (CABG) has shown comparable survival and clinical outcomes to CABG alone.
  • However, the impact of SVR on the risk of cardiac arrhythmias in these patients remains unclear.

Purpose of the Study:

  • To determine the incidence of sudden cardiac death (SCD) and sustained ventricular tachycardia/ventricular fibrillation (VT/VF) after SVR + CABG.
  • To identify clinical and echocardiographic predictors of in-hospital and long-term arrhythmic events.

Main Methods:

  • Retrospective evaluation of 65 patients who underwent SVR + CABG.
  • Analysis included pre- and postoperative clinical data, echocardiography, and electrocardiogram Holter monitoring.

Main Results:

  • At 3 years, the rate of freedom from SCD was 98%, and freedom from any arrhythmic event was 88%.
  • Independent predictors for arrhythmic events were a preoperative left ventricular end-systolic volume index (LVESVI) > 102 mL/m² and postoperative pulmonary artery systolic pressure (PASP) > 27 mmHg.

Conclusions:

  • SVR added to CABG is associated with a low incidence of arrhythmic events, even in high-risk patients.
  • Preoperative LVESVI and postoperative PASP are valuable predictors of arrhythmic events in this population.
Abstract

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