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Titolo:
ENCIRCLING ENDOCARDIAL CRYOABLATION FOR VENTRICULAR-TACHYCARDIA AFTERMYOCARDIAL-INFARCTION - EXPERIENCE WITH 33 PATIENTS
Autore:
GUIRAUDON GM; THAKUR RK; KLEIN GJ; YEE R; GUIRAUDON CM; SHARMA A;
Indirizzi:
UNIV WESTERN ONTARIO HOSP,DEPT SURG,339 WINDERMERE RD LONDON N6A 5A5 ON CANADA UNIV WESTERN ONTARIO HOSP,DEPT MED LONDON N6A 5A5 ON CANADA UNIV WESTERN ONTARIO HOSP,DEPT PATHOL LONDON N6A 5A5 ON CANADA
Titolo Testata:
The American heart journal
fascicolo: 5, volume: 128, anno: 1994,
pagine: 982 - 989
SICI:
0002-8703(1994)128:5<982:EECFVA>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR; SURGICAL-TREATMENT; SUBENDOCARDIAL RESECTION; LASER PHOTOCOAGULATION; MITRAL-VALVE; SURGERY; ABLATION; ARRHYTHMIAS; MANAGEMENT; ANEURYSM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
50
Recensione:
Indirizzi per estratti:
Citazione:
G.M. Guiraudon et al., "ENCIRCLING ENDOCARDIAL CRYOABLATION FOR VENTRICULAR-TACHYCARDIA AFTERMYOCARDIAL-INFARCTION - EXPERIENCE WITH 33 PATIENTS", The American heart journal, 128(5), 1994, pp. 982-989

Abstract

Encircling endocardial cryoablation, consisting of circumferential cryoablation of the infarct scar, can be curative in selected patients with ventricular tachycardia (VT). We describe our experience with and long-term outcome in 33 patients undergoing this procedure. The interval between myocardial infarction and the onset of tachycardia varied from 2 weeks to 22 years (mean 38 +/- 63 months and median 3 months). All patients had a left ventricular aneurysm (anterior in 20, posteriorin 12, and lateral in I)and significant coronary artery disease. Fourteen patients had clinical evidence of heart failure preoperatively. Twenty-eight patients had sustained monomorphic VT (incessant in 3); 3 had polymorphic or nonsustained tachycardia; 2 had primary ventricularfibrillation; and 1 had associated Wolff-Parkinson-White syndrome. Surgery was undertaken after failed drug therapy and consideration of left ventricular anatomy and function. At surgery, 32 patients had encircling endocardial cryoablation, and 1 patient had partial right ventricular free-wall disconnection (right ventricular infarct). Thirteen patients underwent concomitant coronary artery bypass grafting. An implantable cardioverter defibrillator (ICD) was implanted in 2 patients and prophylactic ICD patches in 1. One patient died postoperatively; 3 had recurrent VT perioperatively; 1 was treated with amiodarone; and 2 had ICD implantation. During long-term follow-up (mean 5 years), all patients who were free of tachycardia at discharge remained alive and free of arrhythmias or syncope. The patient receiving amiodarone sustained a cardiac arrest subsequently and received an ICD implant. One patient with an ICD continued to receive appropriate shocks frequently and died 2 years after surgery. Nine patients had congestive heart failure postoperatively. There were 8 late deaths (caused by arrhythmia in 1, heart failure in 4, and terminal cancer in 3). Two patients had heart transplantation (1 and 6 years after surgery). The C-year actuarialsurvival was 77%.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/04/20 alle ore 02:44:04