Ventricular tachycardia surgery: Difference between revisions
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* For [[patients]] with [[ischemic heart disease]] and reduced [[LVEF]] undergoing [[CABG]] the risk of [[sudden cardiac death]] lessened compared with [[medical therapy]]. | * For [[patients]] with [[ischemic heart disease]] and reduced [[LVEF]] undergoing [[CABG]] the risk of [[sudden cardiac death]] lessened compared with [[medical therapy]]. | ||
* In survival of [[SCD]] the risk of [[death]] reduced by [[revascularization]] procedure including [[PCI]] or [[CABG]]. | * In survival of [[SCD]] the risk of [[death]] reduced by [[revascularization]] procedure including [[PCI]] or [[CABG]]. | ||
* [[Ischemic heart disease]] is responsible for 24% to 55% of [[SCD ]] cases in young [[patients]] <35 years of age. | |||
* Anomalous [[aortic]] origin of the [coronary arteries ]] detected in 10% to 17% of [[patients]] in [[postmortem ]] studies, is an important cause of [[SCD]] in the [[young]]. | |||
* [[Revascularization]] is recommended for treating [[ischemia]] leading life-threatening [[ventricular arrhythmia]] due to anomalous [[aortic]] origin of the [[coronary arteries]]. | |||
==Surgery== | ==Surgery== |
Revision as of 05:21, 9 May 2021
Ventricular tachycardia Microchapters |
Differentiating Ventricular Tachycardia from other Disorders |
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Diagnosis |
Treatment |
Case Studies |
Ventricular tachycardia surgery On the Web |
Risk calculators and risk factors for Ventricular tachycardia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery is not a mainstay or a preferred method of treatment for ventricular tachycardia. There are some specific scenarios however in which revascularization may be considered, and may help in preventing VT.
Surgery and Revascularization Procedures in Patients With Ischemic Heart Disease
- Myocardial ischemia is a substrate for sustained polymorphic VT, VF
- Revascularization is a treatment of choice for myocardial ischemia.
- Survival after CABG for life-threatening ventricular arrhythmia was better.
- For patients with ischemic heart disease and reduced LVEF undergoing CABG the risk of sudden cardiac death lessened compared with medical therapy.
- In survival of SCD the risk of death reduced by revascularization procedure including PCI or CABG.
- Ischemic heart disease is responsible for 24% to 55% of SCD cases in young patients <35 years of age.
- Anomalous aortic origin of the [coronary arteries ]] detected in 10% to 17% of patients in postmortem studies, is an important cause of SCD in the young.
- Revascularization is recommended for treating ischemia leading life-threatening ventricular arrhythmia due to anomalous aortic origin of the coronary arteries.
Surgery
According to a few studies and opinions, patients with ventricular tachycardia may be considered for surgery (revascularization) if the underlying cause is coronary heart disease and the patient:[1][2][3][4][5]
- Does not respond to antiarrhythmic drug therapy.
- Has had a cardiac arrest in the past, and had monomorphic VT. This is especially desirable in patients who are already being considered for surgical revascularization.
- Has ventricular tachycardia and a disorder that is pathophysiologically related to the VT (such as postoperative tetralogy of Fallot).
- Despite these ideas, revascularization alone has not been shown to prevent VT from recurring.
References
- ↑ Sartipy U, Albåge A, Strååt E, Insulander P, Lindblom D (January 2006). "Surgery for ventricular tachycardia in patients undergoing left ventricular reconstruction by the Dor procedure". Ann. Thorac. Surg. 81 (1): 65–71. doi:10.1016/j.athoracsur.2005.06.058. PMID 16368337.
- ↑ Guiraudon G, Fontaine G, Frank R, Leandri R, Barra J, Cabrol C (November 1981). "Surgical treatment of ventricular tachycardia guided by ventricular mapping in 23 patients without coronary artery disease". Ann. Thorac. Surg. 32 (5): 439–50. doi:10.1016/s0003-4975(10)61775-4. PMID 7305530.
- ↑ Sartipy U, Löfving A, Albåge A, Lindblom D (June 2008). "Surgery for ventricular tachycardia and left ventricular aneurysm provides arrhythmia control". Scand. Cardiovasc. J. 42 (3): 226–32. doi:10.1080/14017430802005240. PMID 18569956.
- ↑ Horowitz LN, Harken AH, Josephson ME, Kastor JA (July 1981). "Surgical treatment of ventricular arrhythmias in coronary artery disease". Ann. Intern. Med. 95 (1): 88–97. doi:10.7326/0003-4819-95-1-88. PMID 7018338.
- ↑ Doenst T, Faerber G, Grandinac S, Kuntze T, Menicanti L, Borger MA, Mohr FW (June 2007). "Surgical therapy of ventricular arrhythmias". Herzschrittmacherther Elektrophysiol. 18 (2): 62–7. doi:10.1007/s00399-007-0561-1. PMID 17646937.