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Monomorphic versus polymorphic ventricular tachycardia after coronary artery bypass grafting.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Saxon, Leslie Anne Wiener, Isaac Natterson, P. D. Laks, Hillel Drinkwater, Davis C. Stevenson, William Gregory |
| Copyright Year | 1995 |
| Abstract | S ustaincd ventricular tachycardia (VT) or ventricular fibrillation (VF) is an infrequent but life-threatening complication of coronary artery bypass grafting associated with a high mortality.’ The cause is often difficult to determine. Sustained monomorphic VT observed late after myocardial infarction involves reentry through myocyte bands surviving in the infarct.2 Interruption of coronary blood flow by transcoronary ablation can abolish reentry, and restoration of blood flow can bc followed by VT recurrence.3,4 Polymorphic VT/VF is more often due to acute &hernia than to chronic infarct scarring.5-7 We hypothesized that (1) restoring perfusion to electrically quiescent myocardium in chronic infarct scars causes some cases of postoperative VT, and (2) polymorphic VT is associated with perioperativc myocardial infarction. The present report investigated the clinical and electrophysiologic characteristics of patients with sustained VT/VF to determine the association of sustained monomorphic VT and polymorphic VT with prior myocardial infarction, revascularization of infarct scar, and perioperative myocardial infarction. . . . The medical records of 110 consecutive patients referred for ventricular arrhythmia who had undergone coronary artery bypass grafting between 1981 and January of 1993 were reviewed. A total of 17 subjects with documented new-onset sustained VT/VF occurring within 30 days after coronary artery bypass grafting were identified and comprise the study population. A control group was obtained Tom review of 119 consecutive patients discharged from UCLA Medical Center after coronary artery bypass grafting between 1992 and 1993 who did not have postoperative VT. In both groups, cardiac surgery was conducted with moderate hypothermia, cold blood cardioplegia, and warm blood cardioplegia reperfusion. Cardioplegia was administered in both anterograde and retrograde fashion. Patients were excluded from the study if they had any previous cardiac surgery or valvular surgery in addition to bypass grafting. Measurements of left ventricular function were obtained from either preoperative left vcntriculograms or 2-dimensional echocardiography. Zones of prior transmural infarction were identified by both the presence of preoperative Q waves on the 12-lead electrocardiogram and by ventriculographic or echocardiographic evidence of scgmental dyskinesia or akinesia. Operative reports were reviewed for the number and location of coronary artery bypass grafts. |
| Starting Page | 899 |
| Ending Page | 902 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://static1.squarespace.com/static/555251dbe4b0e3bbbdd9d687/t/57c5d2ff59cc685345e916a7/1472582399582/1-s2.0-S0002914999805669-main.pdf |
| PubMed reference number | 7856540v1 |
| Volume Number | 75 |
| Issue Number | 5 |
| Journal | The American journal of cardiology |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Akinesia Bands Cardiac Surgery procedures Cerebral Infarction Cicatrix Coronary Artery Bypass Surgery Dyskinesia, Drug-Induced Echocardiography Electricity Electrocardiography Exclusion Heart Arrest, Induced Hematological Disease Hypothermia due to exposure Left Ventricular Function Monomorphic T/NK-Cell Post-Transplant Lymphoproliferative Disorder Monomorphic Ventricular Tachycardia by ECG Finding Muscle Cells Myocardial Infarction Myocardium Patients Polymorphic ventricular tachycardia Postoperative Complications Reperfusion Therapy Tachycardia, Ventricular Transplanted tissue VENTRICULAR TACHYCARDIA, CATECHOLAMINERGIC POLYMORPHIC, 1 (disorder) Ventricular Fibrillation Ventricular arrhythmia revascularization sustained ventricular tachycardia |
| Content Type | Text |
| Resource Type | Article |
