Ventricular tachycardia surgery: Difference between revisions
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* [[Cardiac surgery]] is rarely performed for treating [[ventricular tachycardia]] in case of highly symptomatic [[patients]] with failed antiarrhythmic medications or [[ventricular]] [[ablation]]. | * [[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 ]]. | * 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]].<ref name="SartipyAlbåge2006">{{cite journal|last1=Sartipy|first1=Ulrik|last2=Albåge|first2=Anders|last3=Strååt|first3=Eva|last4=Insulander|first4=Per|last5=Lindblom|first5=Dan|title=Surgery for Ventricular Tachycardia in Patients Undergoing Left Ventricular Reconstruction by the Dor Procedure|journal=The Annals of Thoracic Surgery|volume=81|issue=1|year=2006|pages=65–71|issn=00034975|doi=10.1016/j.athoracsur.2005.06.058}}</ref> | * [[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]].<ref name="SartipyAlbåge2006">{{cite journal|last1=Sartipy|first1=Ulrik|last2=Albåge|first2=Anders|last3=Strååt|first3=Eva|last4=Insulander|first4=Per|last5=Lindblom|first5=Dan|title=Surgery for Ventricular Tachycardia in Patients Undergoing Left Ventricular Reconstruction by the Dor Procedure|journal=The Annals of Thoracic Surgery|volume=81|issue=1|year=2006|pages=65–71|issn=00034975|doi=10.1016/j.athoracsur.2005.06.058}}</ref><ref name="MulloyBhamidipati2013">{{cite journal|last1=Mulloy|first1=Daniel P.|last2=Bhamidipati|first2=Castigliano M.|last3=Stone|first3=Matthew L.|last4=Ailawadi|first4=Gorav|last5=Bergin|first5=James D.|last6=Mahapatra|first6=Srijoy|last7=Kern|first7=John A.|title=Cryoablation during left ventricular assist device implantation reduces postoperative ventricular tachyarrhythmias|journal=The Journal of Thoracic and Cardiovascular Surgery|volume=145|issue=5|year=2013|pages=1207–1213|issn=00225223|doi=10.1016/j.jtcvs.2012.03.061}}</ref> | ||
==[[ Autonomic Modulation]]== | ==[[ Autonomic Modulation]]== | ||
Revision as of 06:18, 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.[1][2]
Autonomic Modulation
References
- ↑ Sartipy, Ulrik; Albåge, Anders; Strååt, Eva; Insulander, Per; Lindblom, Dan (2006). "Surgery for Ventricular Tachycardia in Patients Undergoing Left Ventricular Reconstruction by the Dor Procedure". The Annals of Thoracic Surgery. 81 (1): 65–71. doi:10.1016/j.athoracsur.2005.06.058. ISSN 0003-4975.
- ↑ Mulloy, Daniel P.; Bhamidipati, Castigliano M.; Stone, Matthew L.; Ailawadi, Gorav; Bergin, James D.; Mahapatra, Srijoy; Kern, John A. (2013). "Cryoablation during left ventricular assist device implantation reduces postoperative ventricular tachyarrhythmias". The Journal of Thoracic and Cardiovascular Surgery. 145 (5): 1207–1213. doi:10.1016/j.jtcvs.2012.03.061. ISSN 0022-5223.