Surgery of life-threatening ventricular tachyarrhythmias associated with ventricular aneurysm

In 11 patients with left ventricular aneurysm and ventricular tachyarrhythmia unresponsive to conventional antiarrhythmic therapy surgical treatment was performed by resection of the aneurysm. One patient underwent epicardial electrophysiological mapping intraoperatively, and the site of earliest activation during tachycardia was established. One patient did 11 hours postoperatively. Three patients are cured from their tachycardia 3 to 22 months after surgery. Six patients have still persistent premature ventricular beats which are now controlled satisfactorily with antiarrhythmic drugs. Our results demonstrate the therapeutic value of aneurysmectomy in the treatment of related ventricular tachyarrhythmias. The practical relevance of intraoperative electrophysiological mapping procedures for localizing the origin of ventricular tachyarrhythmias is a subject which merits further discussion.