Key result
Map-directed VT surgery achieves ~90% drug-free cure rates in selected patients despite declining use after ICDs.
Why the study?
To provide a brief account of the 1980 to 1993 experience and lessons in the diagnosis and surgical ablation of VT and other arrhythmias at Houston Methodist Hospital.
This historical review highlights the evolution and foundational experiences in the surgical and catheter-based management of drug-refractory ventricular tachycardia.
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Historical efficacy of map-directed VT surgery in selected patients leaves open its potential adjunctive role today; modern validation needed.
The treatment of drug-refractory chronic ventricular tachycardia (VT) has undergone a revolution over the last 50 years. We now have automatic implantable cardioverter defibrillator therapy with pace-terminating capabilities, and catheter ablation of VT has refined mapping and improved methods of lesion generation. Between 1980 and 1993, Houston Methodist Hospital became a leader in the diagnosis and surgical ablation of VT and other arrhythmias. This is a brief account of that period and some of the experiences and lessons that have led to significant advances used today.
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Gerald M. Lawrie (2021) conducted a review in Ventricular Tachycardia (n=128). Map-directed ventricular tachycardia surgery (endocardial resection and cryoablation) was evaluated. Map-directed surgery for ventricular tachycardia achieved drug-free cure rates of >90% in properly selected patients, though its use declined with the advent of implantable defibrillators.
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