What is the clinical evidence from this study?

Study design: Cohort. Population: sustained ventricular tachycardia due to coronary artery disease (n=45). Intervention: sequential map-guided subendocardial resection (SER). Primary outcome: survival to hospital discharge.

What question did this study set out to answer?

This study aims to evaluate the effectiveness of sequential map-guided subendocardial resection for treating ventricular tachycardia.

January 1, 1988Circulation

Surgical ablation of ventricular tachycardia with sequential map-guided subendocardial resection: electrophysiologic assessment and long-term follow-up.

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Key result

Sequential map-guided subendocardial resection for sustained ventricular tachycardia resulted in 91% survival to hospital discharge and 76% freedom from arrhythmic events at 42 months.

Why the study?

Does sequential map-guided subendocardial resection improve survival and arrhythmia control in patients with sustained ventricular tachycardia due to coronary artery disease?

Population

45 consecutive patients with sustained ventricular tachycardia due to coronary artery disease, mean age 59…

Design

Case_series

Follow-up

19 +/- 12 months

Authors

DHDavid E. HainesElectrophysiology BLBruce B. LermanElectrophysiology IKIrving L. KronCardiac Surgery

Discussion

Member takes

Implication

Hypothesis-generating for refractory VT; leaves open need for randomized confirmation.

Key Points

This study aims to evaluate the effectiveness of sequential map-guided subendocardial resection for treating ventricular tachycardia.
Examined 45 patients with sustained ventricular tachycardia due to coronary artery disease.
Performed sequential map-guided subendocardial resection or cryothermic ablation during normothermic cardiopulmonary bypass.
Utilized programmed stimulation to assess resection adequacy and monitor tachycardia induction.
91% of patients survived to hospital discharge, with 85% showing no inducible ventricular tachycardia postoperatively.
Four sudden cardiac deaths occurred during a mean follow-up of 19 months, with no nonfatal recurrences of ventricular tachycardia.
Actuarial cardiac survival was 0.57 and freedom from arrhythmic events was 0.76 at 42 months.

Study Design

Type

Cohort (n=45)

Structured PICO

Does sequential map-guided subendocardial resection improve survival and arrhythmia control in patients with sustained ventricular tachycardia due to coronary artery disease?

Population

45 consecutive patients with sustained ventricular tachycardia due to coronary artery disease, mean age 59 +/- 10 years, mean LVEF 34 +/- 12%, 56% with history of myocardial infarction within the previous 2 months.

Intervention

Sequential map-guided subendocardial resection (SER) or cryothermic ablation during normothermic cardiopulmonary bypass, followed by repeated sequences of programmed stimulation to assess adequacy of resection.

Outcome

Operative survival, long-term arrhythmia control (freedom from arrhythmic events), and overall survival.hard clinical

Sequential map-guided subendocardial resection provides high operative survival and excellent long-term arrhythmia control in patients with sustained ventricular tachycardia due to coronary artery disease.

Cite This Study

Haines et al. (1988) conducted a cohort in sustained ventricular tachycardia due to coronary artery disease (n=45). sequential map-guided subendocardial resection (SER) was evaluated on survival to hospital discharge. Sequential map-guided subendocardial resection for sustained ventricular tachycardia resulted in 91% survival to hospital discharge and 76% freedom from arrhythmic events at 42 months.

synapsesocial.com/papers/6a0edf82aa1655e5fb22ee59 https://doi.org/10.1161/01.cir.77.1.131

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Surgical ablation of ventricular tachycardia with sequential map-guided subendocardial resection: electrophysiologic assessment and long-term follow-up.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Surgical ablation of ventricular tachycardia with sequential map-guided subendocardial resection: electrophysiologic assessment and long-term follow-up.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider