[Therapy-refractory permanent ventricular tachycardia in the immediate postinfarct period--treatment using...

Endocardial encircling ventriculotomy was carried out in a 47-year-old male patient because of recurrent drug-resistant permanent ventricular tachycardia complicating acute myocardial infarction. Earliest activation during ventricular tachycardia determined by intraoperative mapping was recorded from the left side of the interventricular septum. At this site, a parital encircling endocardial ventriculotomy was performed. Postoperatively, there was no spontaneous recurrence of ventricular tachycardia. During a postoperative electrophysiologic study, no ventricular tachycardia could be induced. These results indicate that map-guided surgery may be carried out successfully in selected patients with drug-resistant ventricular tachycardia complicating the acute phase of myocardial infarction.