HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Levi Watkins, Jr. Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Watkins, L. Articles by Reid, P. R. Search for Related Content PubMed PubMed Citation Articles by Watkins, L., Jr. Articles by Reid, P. R.

Ann Thorac Surg 1984;37:60-66
© 1984 The Society of Thoracic Surgeons

---

Articles

The Treatment of Malignant Ventricular Arrhythmias with Combined Endocardial Resection and Implantation of the Automatic Defibrillator: Preliminary Report

From the Departments of Surgery and Medicine, The Johns Hopkins Medical Institutions, Baltimore, MD and the Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD

Fourteen patients with refractory ventricular tachyarrhythmias were treated with combined endocardial resection and implantation of the automatic defibrillator. There were 11 men and 3 women with a mean age of 53 years (range, 41 to 58 years). All patients had coronary artery disease; the mean ejection fraction was 26%, and the mean number of cardiac arrests was 2.6. Programmed electrical stimulation induced sustained ventricular tachycardia in 13 patients and nonsustained ventricular tachycardia in 1.

Operative endocardial mapping in the 13 patients with sustained ventricular tachycardia demonstrated a septal focus of early activation in 9 patients and a nonseptal site in 4. Following resection, sustained ventricular tachycardia could not be reinduced. There was 1 operative death. Programmed electrical stimulation performed one month after operation induced ventricular tachycardia in 5 patients, but tachycardia could not be induced in the other 8 survivors.

The longest follow-up was 32 months; the average was 17 months. There were 2 late deaths. One patient died of myocardial infarction and 1 of pulmonary edema following a routine cholecystectomy. In another patient, late ventricular tachycardia developed but was automatically terminated by the implanted defibrillator. These results suggest that endocardial resection combined with implantation of the automatic defibrillator may offer the greatest protection yet available to patients with malignant ventricular tachyarrhythmias.

This article has been cited by other articles:

				P. C. Fotuhi, R. E. Ideker, S. F. Idriss, R. L. Callihan, R. G. Walker, and E. U. Alt Influence of Epicardial Patches on Defibrillation Threshold With Nonthoracotomy Lead Configurations Circulation, November 15, 1995; 92(10): 3082 - 3088. [Abstract] [Full Text]

				E. S. Yee Automatic Implantable Cardioverter Defibrillators: Surgical Approaches for Optimal Function Vascular and Endovascular Surgery, November 1, 1989; 23(6): 458 - 463. [Abstract] [PDF]

				A. S. Manolis, H. Rastegar, and N. A. M. Estes III Automatic Implantable Cardioverter Defibrillator: Current Status JAMA, September 8, 1989; 262(10): 1362 - 1368. [Abstract] [PDF]

				J. G. Selle, R. H. Svenson, W. C. Sealy, J. J. Gallagher, S. H. Zimmern, J. M. Fedor, M.-C. Marroum, and F. Robicsek Successful Clinical Laser Ablation of Ventricular Tachycardia: A Promising New Therapeutic Method Ann. Thorac. Surg., October 1, 1986; 42(4): 380 - 384. [Abstract] [PDF]