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[Results of surgical treatment of ventricular tachycardia]
Insights
Surgical intervention effectively treats drug-resistant ventricular tachycardia (VT). This study shows a 76% success rate in patients with ischemic and non-coronary heart disease, offering a viable treatment option.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Context:
- Ventricular tachycardia (VT) refractory to medical management requires alternative treatments.
- Surgical intervention is considered the primary treatment for drug-resistant VT.
- Understanding the underlying etiology is crucial for surgical planning and success.
Purpose:
- To evaluate the efficacy of surgical treatment for ventricular tachycardia (VT) of various etiologies.
- To compare surgical outcomes in patients with ischemic versus non-coronary heart disease.
- To identify the location of arrhythmogenic foci using endo- and epicardial mapping.
Summary:
- Fifty-six patients with VT were divided into ischemic (17 patients) and non-coronary (39 patients) groups.
- Surgical success rates were 72% for ischemic VT and 79% for non-coronary VT.
- Overall, surgical treatment achieved a 76% success rate for VT across both groups, with follow-up ranging from 2 months to 6 years.
Impact:
- Surgical treatment offers a high success rate for drug-refractory ventricular tachycardia.
- The findings support surgical intervention as a definitive treatment for VT.
- Identifying the arrhythmogenic focus improves surgical outcomes and patient prognosis.
Abstract:
Surgical treatment is the method of choice in patients with ventricular tachycardia refractive to drug therapy. Fifty-six patients with ventricular tachycardia of various genesis were examined and separated into two groups according to the main heart disease. Group 1 was formed of patients with ischemic heart disease. In 16 of the 17 patients of this group disorders of left-ventricular contractility were revealed, the ejection fraction varied from 18 to 56% (average 32 +/- 13.8%). The attacks of ventricular tachycardia in patients of group 1 were characterized by an extremely severe course and cardioversion had to be resorted to repeatedly in order to relieve them. Endo- and epicardial mapping revealed localization of the arrhythmogenic focus on the boundary of the myocardial area involved in fibrosis. Surgical treatment was successful in 72% of cases in this group. Group 2 included patients with ventricular tachycardia of noncoronary genesis. In electrophysiological examination tachycardia could not be induced in 6 patients of this group. In 12 of 39 patients attacks of tachycardia were not attended by hemodynamic disorders. Contractility of the left-ventricular myocardium was disturbed only in 14 (36%) patient. The arrhythmogenic focus was in the right ventricle in 22 patients and in the left ventricle in 11 patients. Operation was performed on 29 patients of this group. The arrhythmogenic focus was successfully removed in 79% of cases. Surgical treatment of ventricular tachycardias of various genesis was successful in 76% of cases in follow-up periods of 2 months to 6 years.