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Excisional surgery for patients with ventricular tachyarrhythmias
1Vanderbilt University Medical Center, Department of Cardiac and Thoracic Surgery, Nashville, Tennessee.
Journal of Cardiac Surgery
|September 1, 1987
Summary
Surgical intervention for drug-refractory ventricular tachycardia offers a high success rate. Direct operations provide a viable treatment option with reasonable risk for patients with specific arrhythmia types.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Drug-refractory ventricular tachycardia poses significant management challenges.
- Surgical options are considered for patients unresponsive to medical therapy.
Purpose of the Study:
- To evaluate the safety and efficacy of direct surgical intervention for drug-refractory ventricular tachycardia.
- To identify patient subgroups that benefit most from surgical treatment.
Main Methods:
- Intraoperative mapping, subendocardial resection, and cryolesions were employed.
- Preoperative localization was attempted in select patients.
Main Results:
- Operative mortality was 13% (5/38), with 2 deaths due to recurrent arrhythmia.
- 64% (21/33) of survivors were cured, and 9 additional patients achieved medication control.
- Best outcomes were observed in patients with anteroapical scars and unifocal tachycardia.
Conclusions:
- Direct surgical operation for drug-refractory ventricular tachycardia is feasible with acceptable risk.
- Successful arrhythmia control can be achieved in a high percentage of appropriately selected patients.