Results of Direct Surgical Ablation of Ventricular Tachycardia Not Due to Ischemic Heart Disease

Surgical treatment of sustained ventricular tachycardia due to nonischemic causes is uncommon. Nonischemic ventricular tachycardia was treated in 14 patients by map-directed surgical ablation of an arrhythmogenic site. There were 9 male and 5 female patients. The mean age was 33 +/- 13.4 years (range, 15 to 57 years). The etiology was idiopathic in 4 patients, cardiomyopathy in 3, acute myocarditis in 1, arrhythmogenic right ventricular dysplasia in 2, tumor in 1, postoperative Tetralogy of Fallot in 2, and acute bacterial endocarditis in 1. Pre- and/or intraoperative electrophysiologic mapping was achieved in 13 of 14 patients. A variety of operations were performed without death. Two late deaths have occurred, neither of them, however, from arrhythmias. After operation two patients had recurrent arrhythmias. Surgery for nonischemic ventricular tachycardia is safe and effective and should be considered early in the course of these mostly young patients.