Risk stratification and management of patients with recurrent ventricular tachycardia and other malignant ventricular arrhythmias

W. C. Hargrove, John Miller

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Clinical results are reviewed in 269 patients who underwent subendocardial resection for recurrent sustained ventricular tachycardia secondary to ischemic heart disease. Operative mortality is 15%. Factors increasing operative mortality rates are ejection fraction less than 20%, emergency operation, and history of previous heart operation. Use of amiodarone preoperatively does not alter operative risk. Clinical control of ventricular tachycardia is achieved in 93% of operative survivors. Two thirds of these patients do not need antiarrhythmic agents. Five-year actuarial survival is approximately 60%. Patient results with the automatic internal cardioverter defibrillator at the Hospital of the University of Pennsylvania and nationwide are also reviewed. As of June 1987, almost 1,500 patients had one or more devices implanted. Most patients had a prior documented cardiac arrest. Coronary artery disease is the cause of heart disease in over 70% of patients. Operative mortality is low (0.8-3.9%). Approximately 50% of patients have had therapeutic discharge of the device; however, asymptomatic discharge occurs in up to 45% of patients. Incidence of sudden death is 1.5% at 1 year and 5% at 5 years. Five-year actuarial survival is approximately 60%. Long-term mortality is primarily from heart failure.

Original languageEnglish (US)
JournalCirculation
Volume79
Issue number6 SUPPL.
StatePublished - 1989
Externally publishedYes

Fingerprint

Risk Management
Ventricular Tachycardia
Cardiac Arrhythmias
Mortality
Equipment and Supplies
Defibrillators
Survival
Amiodarone
Sudden Death
Heart Arrest
Myocardial Ischemia
Survivors
Coronary Artery Disease
Heart Diseases
Emergencies
Heart Failure
Incidence

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Risk stratification and management of patients with recurrent ventricular tachycardia and other malignant ventricular arrhythmias. / Hargrove, W. C.; Miller, John.

In: Circulation, Vol. 79, No. 6 SUPPL., 1989.

Research output: Contribution to journalArticle

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