REFRACTORY VENTRICULAR ARRHYTHMIA - ROLE OF INTRAOPERATIVE ELECTROPHYSIOLOGICAL STUDY

  • 1 January 1977
    • journal article
    • research article
    • Vol. 82  (6) , 809-815
Abstract
Patients (30) with drug refractory ventricular tachycardia (RVT) were studied between 1 wk and 5 yr after myocardial infarction with coronary angiography and left ventriculography. They were divided into 4 groups: (1) inoperable, 5 patients; (2, a) operated, with primary left ventricular failure, 5 patients; (2, b) operated with primary RVT, not mapped, 15 patients; (2, c) operated, with mapping, 5 patients. The mortality rate in group 1 was 100%, and in group 2, a it was 80%. In group 2, b, despite aggressive drug therapy and operation, including aneurysmectomy, coronary revascularization and intra-aortic balloon pumping when appropriate, the mortality rate was 60-33% early and 27% late. These results prompted electrophysiological studies and intraoperative mapping in group 2, c. Arrhythmogenic foci were identified and removed in 4. There was 1 operative death (20%) and 4 patients are alive from 12-27 mo. after operation, 3 of whom are asymptomatic. Intraoperative epicardial mapping is an important adjunct to surgery for RVT.

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