Surgery of ventricular tachycardia and ventricular fibrillation in patients with coronary artery disease and LV-Aneurysms

Abstract

In 26 patients with left ventricular aneurysm and ventricular tachycardia and/or ventricular fibrillation following myocardial infarction, coronary angiography, left ventriculography and electrophysiologic examination were performed preoperatively. Surgery in all cases consisted of aneurysmectomy and mapping-guided endocardial resection of the area found to be the arrhythmogenic center. Four patients died peroperatively or during the postoperative hospital stay. The 22 survivors were followed up for 3-48 (mean 22) months postoperatively. There were no late deaths. Repeated electrophysiologic studies were performed in 18 of the survivors. Freedom from ventricular tachycardia and fibrillation was achieved in 21 patients, 17 after surgery alone and four after combined surgical and medical treatment. The remaining patient still has ventricular tachycardia despite combined treatment.

Nonpharmacologic Treatment of Supraventricular and Ventricular Tachyarrhythmias: A Review of 249 Consecutive Patients

“…In patients with SVT the electrophysiologic study was performed as previously described (8,11). Briefly, three electrode catheters were inserted percutaneously via the right femoral vein and fluoroscopically guided to the heart.…”

“…As in operations for SVT, a specially designed quadripolar reference and pacing electrode was sutured to the epicardium of the right ventricular outflow tract close to the interventricular septum (8). As in operations for SVT, a specially designed quadripolar reference and pacing electrode was sutured to the epicardium of the right ventricular outflow tract close to the interventricular septum (8).…”