Predictors of new malignant ventricular arrhythmias after coronary surgery

Abstract

The incidence of VT/VF is low in patients undergoing coronary surgery but is associated with high in-hospital mortality. The late survival of the discharged VT/VF patients compares favorably with that of controls.

Factors Influencing Appropriate Firing of the Implanted Defibrillator for Ventricular Tachycardia/Fibrillation

“…Myocardial ischemia and its association with ventricular arrhythmias are well described. Recent data have shown angina to be a predictor of new malignant arrhythmias in patients with coronary artery disease (25). There are, however, scant prospective data showing this mechanistic relationship between angina and ICD therapy in patients with coronary artery disease.…”

Postoperative Life-Threatening Recurrent Ventricular Arrhythmia Triggered by the Swan-Ganz Catheter in a Patient Undergoing Off-Pump Coronary Artery Bypass Surgery

“…The occurrence of ventricular tachycardia (VT) or VF after CABG has been reported to have a strong impact on in-hospital mortality, which ranged from 21.7% to 25% [1,2]. Recurrent ventricular arrhythmia was not infrequent, observed in 33% of the patients, and was associated with a high mortality; 75% of the patients with these characteristics did not survive to hospital discharge [1].…”

“…Recurrent ventricular arrhythmia was not infrequent, observed in 33% of the patients, and was associated with a high mortality; 75% of the patients with these characteristics did not survive to hospital discharge [1]. The known risk factors for ventricular arrhythmia after CABG are age under 65 years, female gender, body mass index under 25 kg/m 2 , unstable angina, moderate or poor ejection fraction, and a need for pre-operative inotropic support or an intra-aortic balloon pump [2]. …”

Postoperative arrhythmias

“…Herzchirurgische Patienten mit erheblich eingeschränkter linksventrikulärer Ejektionsfraktion haben augenscheinlich das größte Risiko für lebensbedrohliche VT oder VF (6,12). Nachdem diese Tachykardien bei knapp 50% der belasteten Patienten innerhalb der ersten 24 Stunden postoperativ auftreten und die VT/VF-assoziierte Letalität exakt innerhalb der unmittelbaren post- (5,12), ist hier eine zügige Diagnostik, beispielsweise mittels Echokardiographie und Herzkatheteruntersuchung geboten. Therapeutisch müssen VT/VF mit hämodynami-scher Instabilität sofort durch Defibrillation beendet werden.…”