Comprehensive arrhythmic surgery for sustained ventricular tachycardia revisited

Area of Science:

• Cardiology
• Cardiac Surgery

Background:

• Sustained ventricular tachycardia (VT) poses a significant risk, especially in patients with ischemic heart disease.
• Radiofrequency catheter ablation is a common treatment, but surgical intervention may be necessary for complex cases.

Observation:

• A 68-year-old woman with a history of myocardial infarction presented with sustained VT.
• She had double vessel coronary disease, a dilated left ventricle with an inferior aneurysm, and reduced systolic function.

Findings:

• A comprehensive surgical approach was performed, including subendocardial resection, cryoablation, aneurysmectomy, left ventricular reconstruction, and coronary artery bypass grafting.
• An implantable cardioverter-defibrillator was also implanted.
• The patient remained free of VT recurrence for one year post-surgery.

Implications:

• Surgical ablation is a viable and effective option for selected patients with sustained VT, particularly those requiring concomitant left ventricular aneurysmectomy and coronary artery bypass grafting.
• This combined surgical strategy can lead to a better long-term prognosis by achieving complete VT cure.
• This case highlights the importance of individualized treatment strategies in managing complex cardiac conditions.