De novo refractory ventricular tachyarrhythmias after coronary revascularization Academic Article Article uri icon

Overview

MeSH Major

  • Catheter Ablation
  • Tachycardia, Ventricular

abstract

  • Twelve of 1,675 patients who underwent coronary artery bypass grafting during a 2.5-year period had new onset, recurrent, sustained ventricular tachyarrhythmia a mean of 27 days (range 2 to 150) postoperatively. No patient had an intra- or perioperative myocardial infarction and all patients were hemodynamically stable and had normal metabolic and electrolytic indexes at the time of ventricular tachyarrhythmia. Preoperative ejection fraction was 39 +/- 10% (mean +/- standard deviation) and all patients had Lown grade II or less ventricular ectopic activity on ambulatory monitoring. Postoperative angiography demonstrated occluded saphenous vein grafts in 3 of 7 patients studied, none of whom had symptoms suggestive of myocardial ischemia. Treatment with conventional antiarrhythmic therapy was unsuccessful in all but 1 patient, and 10 patients were treated with amiodarone and 1 patient with propafenone. Four of these patients also received an automatic implantable defibrillator. Thus, de novo ventricular tachyarrhythmia can occur unexpectedly after coronary artery bypass grafting and may be the result of several factors related to either subclinical graft occlusion or increased dispersion of repolarization secondary to reperfusion.

publication date

  • January 1986

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1016/0002-9149(86)90951-3

PubMed ID

  • 3484603

Additional Document Info

start page

  • 57

end page

  • 9

volume

  • 57

number

  • 1