Direct surgery for drug-resistant, non-ischemic ventricular tachycardia resulted in complete disappearance of VT without antiarrhythmic therapy in 83% of patients, with an 89% 10-year survival rate.
Observational (n=43)
Does direct surgery based on electrophysiological data improve freedom from recurrent VT and survival in patients with drug-resistant non-ischemic VT?
Surgical management for drug-resistant non-ischemic VT is effective, offering a high chance of long-term cure without the need for antiarrhythmic therapy.
Drug resistant, non-ischemic ventricular tachycardia (VT) was treated in 43 patients by direct surgery based on electrophysiological data. Two main surgical techniques were employed: myocardium was resected followed by cryocoagulation with a special probe in 23 patients with VT originating from the right ventricle. The myocardium was incised followed by cryocoagulation in 10 patients with VT from the left ventricle. The follow-up period ranged from 1 week to 10 years, 4 weeks (mean 3 years, 8 months). After operation, 36 patients (83%) showed complete disappearance of VT without antiarrhythmic therapy. Of these 2 patients died of congestive heart failure not related to VT in the postoperative period at 1 year 4 months, and 2 years 4 months, respectively. In 7 patients, VT remained. In 2, VT disappeared after catheter ablation. In 3 patients, VT became controllable with antiarrhythmic therapy. Operation was not successful in 2 patients (5%); 1 with a giant left ventricular aneurysm died of low cardiac output syndrome due to VT 1 week after operation; the other with arrhythmogenic right ventricular dysplasia originating from both ventricles died suddenly 5 months after operation. The 10-year survival is 89%, and the 10-year freedom from recurrent VT is 83%. These results indicate that surgical management for non-ischemic VT is safe and effective with a high chance of cure.
Iwa et al. (Tue,) conducted a observational in Drug resistant, non-ischemic ventricular tachycardia (n=43). Direct surgery based on electrophysiological data was evaluated on Complete disappearance of VT without antiarrhythmic therapy. Direct surgery for drug-resistant, non-ischemic ventricular tachycardia resulted in complete disappearance of VT without antiarrhythmic therapy in 83% of patients, with an 89% 10-year survival rate.