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Ann Thorac Surg 1989;48:85-89
© 1989 The Society of Thoracic Surgeons

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Articles

Coronary artery bypass grafting in patients with ventricular fibrillation

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, and Division of Cardiology, Department of Internal Medicine, University of Virginia Medical Center, Charlottesville, Virginia USA

Accepted for publication February 13, 1989.

^_* Address reprint requests to Dr Kron, Department of Surgery, Box 181, University of Virginia Medical Center, Charlottesville, VA 22908.

The role of coronary artery revascularization in the management of survivors of cardiac arrest remains controversial. Patients with sustained monomorphic ventricular tachycardia rarely respond to revascularization, but the response of patients with ventricular fibrillation as their basic arrhythmia has not been characterized. Coronary artery bypass grafting was performed in 8 patients with a history of cardiac arrest known to be caused by ventricular fibrillation without preceding sustained monomorphic ventricular tachycardia. All patients had critical double-vessel or triple-vessel coronary artery disease, and 7 of 8 had wall motion abnormalities from a prior myocardial infarction. After successful operation, 5 patients had no spontaneous arrhythmias and no inducible arrhythmias at a postoperative electrophysiological study, Three patients, however, had spontaneous, recurrent episodes of ventricular fibrillation unassociated with recurrent ischemic. Clinical factors were not useful predictors of response. The effect of coronary artery revascularization in patients with ventricular fibrillation is unpredictable, and full postoperative electrophysiological evaluation is necessary to judge the success of the procedure.

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