Results of electrophysiologically guided operations for drug-resistant recurrent ventricular tachycardia and ventricular fibrillation due to coronary artery disease

R. Brodman, John Devens Fisher, D. R. Johnston, S. G. Kim, J. A. Matos, L. E. Waspe, G. M. Scavin, S. Furman

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Over a 39 month period, 143 patients with coronary artery disease had programmed stimulation (PES) for recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF). Twenty-two patients underwent operations. Ages ranged from 40 to 71 years; 20 of the 22 were men. All patients had coronary artery disease and 11 had left ventricular aneurysms. The mean ejection fraction was 31% (16% to 50%). Eighteen of the 22 patients underwent operations for drug-resistant ventricular arrhythmias (more than six different drugs plus drug combinations tested per patient). Nineteen patients had intraoperative mapping, endocardial resection, and/or an encircling endocardial ventriculotomy. Three patients with ischemia-related VT had coronary artery bypass (CABG) alone. The 30 day operative mortality was 14%. Thirteen of 19 (68%) operative survivors were effectively controlled with operation alone or a combination of operation and previously ineffective drug therapy. Of the six patients whose VT was inducible postoperatively, three have experienced episodes of sustained VT and one patient died suddenly. Three of these patients have the automatic implantable defibrillator. Operation guided by endocardial mapping is effective alone or in combination with drugs in this select group of patients. If the patients' VT was uninducible postoperatively with or without the addition of antiarrhythmic therapy, late deaths (3/19) were due to poor myocardial reserve and coronary artery disease, not the reemergence of sustained ventricular arrhythmias during a mean follow-up of 15 months.

Original languageEnglish (US)
Pages (from-to)431-438
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume87
Issue number3
StatePublished - 1984

Fingerprint

Ventricular Fibrillation
Ventricular Tachycardia
Coronary Artery Disease
Pharmaceutical Preparations
Drug Combinations
Cardiac Arrhythmias
Implantable Defibrillators
Coronary Artery Bypass
Aneurysm
Survivors
Ischemia
Drug Therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Results of electrophysiologically guided operations for drug-resistant recurrent ventricular tachycardia and ventricular fibrillation due to coronary artery disease. / Brodman, R.; Fisher, John Devens; Johnston, D. R.; Kim, S. G.; Matos, J. A.; Waspe, L. E.; Scavin, G. M.; Furman, S.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 87, No. 3, 1984, p. 431-438.

Research output: Contribution to journalArticle

Brodman, R. ; Fisher, John Devens ; Johnston, D. R. ; Kim, S. G. ; Matos, J. A. ; Waspe, L. E. ; Scavin, G. M. ; Furman, S. / Results of electrophysiologically guided operations for drug-resistant recurrent ventricular tachycardia and ventricular fibrillation due to coronary artery disease. In: Journal of Thoracic and Cardiovascular Surgery. 1984 ; Vol. 87, No. 3. pp. 431-438.
@article{f22b5e342c5f4cdaa4a29f8df1058a59,
title = "Results of electrophysiologically guided operations for drug-resistant recurrent ventricular tachycardia and ventricular fibrillation due to coronary artery disease",
abstract = "Over a 39 month period, 143 patients with coronary artery disease had programmed stimulation (PES) for recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF). Twenty-two patients underwent operations. Ages ranged from 40 to 71 years; 20 of the 22 were men. All patients had coronary artery disease and 11 had left ventricular aneurysms. The mean ejection fraction was 31{\%} (16{\%} to 50{\%}). Eighteen of the 22 patients underwent operations for drug-resistant ventricular arrhythmias (more than six different drugs plus drug combinations tested per patient). Nineteen patients had intraoperative mapping, endocardial resection, and/or an encircling endocardial ventriculotomy. Three patients with ischemia-related VT had coronary artery bypass (CABG) alone. The 30 day operative mortality was 14{\%}. Thirteen of 19 (68{\%}) operative survivors were effectively controlled with operation alone or a combination of operation and previously ineffective drug therapy. Of the six patients whose VT was inducible postoperatively, three have experienced episodes of sustained VT and one patient died suddenly. Three of these patients have the automatic implantable defibrillator. Operation guided by endocardial mapping is effective alone or in combination with drugs in this select group of patients. If the patients' VT was uninducible postoperatively with or without the addition of antiarrhythmic therapy, late deaths (3/19) were due to poor myocardial reserve and coronary artery disease, not the reemergence of sustained ventricular arrhythmias during a mean follow-up of 15 months.",
author = "R. Brodman and Fisher, {John Devens} and Johnston, {D. R.} and Kim, {S. G.} and Matos, {J. A.} and Waspe, {L. E.} and Scavin, {G. M.} and S. Furman",
year = "1984",
language = "English (US)",
volume = "87",
pages = "431--438",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Results of electrophysiologically guided operations for drug-resistant recurrent ventricular tachycardia and ventricular fibrillation due to coronary artery disease

AU - Brodman, R.

AU - Fisher, John Devens

AU - Johnston, D. R.

AU - Kim, S. G.

AU - Matos, J. A.

AU - Waspe, L. E.

AU - Scavin, G. M.

AU - Furman, S.

PY - 1984

Y1 - 1984

N2 - Over a 39 month period, 143 patients with coronary artery disease had programmed stimulation (PES) for recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF). Twenty-two patients underwent operations. Ages ranged from 40 to 71 years; 20 of the 22 were men. All patients had coronary artery disease and 11 had left ventricular aneurysms. The mean ejection fraction was 31% (16% to 50%). Eighteen of the 22 patients underwent operations for drug-resistant ventricular arrhythmias (more than six different drugs plus drug combinations tested per patient). Nineteen patients had intraoperative mapping, endocardial resection, and/or an encircling endocardial ventriculotomy. Three patients with ischemia-related VT had coronary artery bypass (CABG) alone. The 30 day operative mortality was 14%. Thirteen of 19 (68%) operative survivors were effectively controlled with operation alone or a combination of operation and previously ineffective drug therapy. Of the six patients whose VT was inducible postoperatively, three have experienced episodes of sustained VT and one patient died suddenly. Three of these patients have the automatic implantable defibrillator. Operation guided by endocardial mapping is effective alone or in combination with drugs in this select group of patients. If the patients' VT was uninducible postoperatively with or without the addition of antiarrhythmic therapy, late deaths (3/19) were due to poor myocardial reserve and coronary artery disease, not the reemergence of sustained ventricular arrhythmias during a mean follow-up of 15 months.

AB - Over a 39 month period, 143 patients with coronary artery disease had programmed stimulation (PES) for recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF). Twenty-two patients underwent operations. Ages ranged from 40 to 71 years; 20 of the 22 were men. All patients had coronary artery disease and 11 had left ventricular aneurysms. The mean ejection fraction was 31% (16% to 50%). Eighteen of the 22 patients underwent operations for drug-resistant ventricular arrhythmias (more than six different drugs plus drug combinations tested per patient). Nineteen patients had intraoperative mapping, endocardial resection, and/or an encircling endocardial ventriculotomy. Three patients with ischemia-related VT had coronary artery bypass (CABG) alone. The 30 day operative mortality was 14%. Thirteen of 19 (68%) operative survivors were effectively controlled with operation alone or a combination of operation and previously ineffective drug therapy. Of the six patients whose VT was inducible postoperatively, three have experienced episodes of sustained VT and one patient died suddenly. Three of these patients have the automatic implantable defibrillator. Operation guided by endocardial mapping is effective alone or in combination with drugs in this select group of patients. If the patients' VT was uninducible postoperatively with or without the addition of antiarrhythmic therapy, late deaths (3/19) were due to poor myocardial reserve and coronary artery disease, not the reemergence of sustained ventricular arrhythmias during a mean follow-up of 15 months.

UR - http://www.scopus.com/inward/record.url?scp=0021348416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021348416&partnerID=8YFLogxK

M3 - Article

C2 - 6700249

AN - SCOPUS:0021348416

VL - 87

SP - 431

EP - 438

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 3

ER -