The Annals of Thoracic Surgery, Vol 30, 499-508, Copyright © 1980 by The Society of Thoracic Surgeons
The surgical treatment of ventricular tachycardia
AH Harken, LN Horowitz and ME Josephson
Recurrent ventricular tachycardia is a well-recognized complication of
ischemic heart disease. Coronary bypass operation with or without
aneurysmectomy has been disappointing as therapy for these arrhythmias.
With the advent of programmed electrical stimulation, it has become
possible to distinguish automatic and reentrant ventricular
tachyarrhythmias. The latter have recently proved amenable to operative
intervention. This review examines the pathophysiology and diagnosis of
ventricular tachycardia using programmed electrical stimulation. Surgical
therapy with resection, revascularization, autonomic modulation, thermal
ablation, cardiac pacing, reentrant circuit interruption, and endocardial
excision is explored. Operation for cardiac arrhythmias is on a firm
electrophysiological foundation. Surgical treatment of refractory
ventricular tachyarrhythmias is now rational, recommended, and rewarding.