Ventricular tachycardia surgery: Difference between revisions
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* [[Myocardial ischemia]] is a substrate for sustained [[polymorphic VT]], or [[VF]]. | * [[Myocardial ischemia]] is a substrate for sustained [[polymorphic VT]], or [[VF]]. | ||
* [[Revascularization]] is a treatment of choice for [[myocardial ischemia]]. | * [[Revascularization]] is a treatment of choice for [[myocardial ischemia]]. | ||
* [[Survival]] after [[CABG]] | * [[Survival]] after [[CABG]] in [[patients]] with life-threatening [[ventricular arrhythmia]] was reasonable. | ||
* 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]]. | ||
* | * Among 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. | * [[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]]. | * 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]]. | ||
Revision as of 06:02, 9 May 2021
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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Diagnosis |
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Treatment |
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Case Studies |
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Ventricular tachycardia surgery On the Web |
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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.
Revascularization Procedures in Patients With Ischemic Heart Disease
- Myocardial ischemia is a substrate for sustained polymorphic VT, or VF.
- Revascularization is a treatment of choice for myocardial ischemia.
- Survival after CABG in patients with life-threatening ventricular arrhythmia was reasonable.
- For patients with ischemic heart disease and reduced LVEF undergoing CABG, the risk of sudden cardiac death lessened compared with medical therapy.
- Among 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 for arrhythmia management
- Cardiac surgery is rarely performed for treating ventricular tachycardia in case of highly symptomatic patients with failed antiarrhythmic medications or ventricular ablation.
- Inaccessible sites for ventricular ablation including area deep in the myocardium, beneath epicardial fat, or near the coronary arteries .
- Surgical ablation of ventricular arrhythmia can be done during other surgical intervention such as placement of LVAD or at the time of left ventricular aneurysectomy which is a substrate for VT.