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January 23, 1986New England Journal of Medicine

Treatment of Malignant Ventricular Arrhythmias with Endocardial Resection and Implantation of the Automatic Cardioverter-Defibrillator

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Why the study?

Does implantation of an automatic cardioverter-defibrillator in conjunction with endocardial resection prevent recurrent ventricular tachyarrhythmias or sudden death in patients with drug-refractory ventricular arrhythmias and prior myocardial infarction?

Population

28 patients with drug-refractory ventricular arrhythmias, all of whom had previous myocardial infarctions…

Design

Case_series

Follow-up

8 to 51 months (mean, 25)

Authors

EPEdward V. PlatiaGeorgetown UniversityLGLawrence S.C. GriffithSouth Australian Health and Medical Research InstituteLWLevi WatkinsUniversity of Maryland, Baltimore

Discussion

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Implication

May support combined device-resection protection in refractory post-MI VT; hypothesis-generating and leaves open need for controlled trials.

Structured PICO

Does implantation of an automatic cardioverter-defibrillator in conjunction with endocardial resection prevent recurrent ventricular tachyarrhythmias or sudden death in patients with drug-refractory ventricular arrhythmias and prior myocardial infarction?

P
Population
28 patients with drug-refractory ventricular arrhythmias, all of whom had previous myocardial infarctions and between one and five cardiac arrests.
I
Intervention
Implantation of an automatic cardioverter-defibrillator in conjunction with mapping-directed endocardial resection.
O
Outcome
Recurrence of hypotensive ventricular tachycardia or sudden deathhard clinical

Implantation of an automatic cardioverter-defibrillator during endocardial resection provides effective protection against recurrent ventricular tachyarrhythmias and sudden death in high-risk patients.

Cite This Study

Platia et al. (1986) studied this question.

synapsesocial.com/papers/6a9679d996bab72bf50e27fahttps://doi.org/10.1056/nejm198601233140405
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ventricular Resection Guided by Epicardial and Endocardial Mapping for Treatment of Recurrent Ventricular Tachycardia1980 · 319 citations
  2. 2Clinical experience, complications, and survival in 70 patients with the automatic implantable cardioverter/defibrillator.1985 · 452 citations
  3. 3Mortality in Patients with Implanted Automatic Defibrillators1983 · 313 citations
  4. 4Termination of Malignant Ventricular Arrhythmias with an Implanted Automatic Defibrillator in Human Beings1980 · 1,366 citations
  5. 5Surgery for ventricular tachycardia: efficacy of left ventricular aneurysm resection compared with operation guided by electrical activation mapping.1982 · 95 citations