Surgical therapy of ventricular arrhythmias

T. Doenst, G. Faerber, S. Grandinac, T. Kuntze, L. Menicanti, M. A. Borger, F. W. Mohr

Research output: Contribution to journalArticle

Abstract

Since the advent of implantable cardioverters/defibrillators (ICD) and percutaneous ablation, surgery for the treatment of ventricular arrhythmia has decreased tremendously. Nevertheless, surgical treatment of ventricular arrhythmias is still required, especially for cases where ICD discharge occurs very frequently or in patients with other indications for surgery. The choice of surgical therapy may range from radiofrequency- or cryoablation of a single focus (identified either intra- operatively or percutaneously) to more extensive surgical procedures such as surgical ventricular reconstruction with endocardial resection or even resection of the right ventricle and the creation of a cavo-pulmonary circulation for malignant arrhythmias and right ventricular failure in patients with arrhythmogenic right ventricular dysplasia. However, the choice of surgical procedure should be made based on the pathomechanism of the arrhythmia. This is important because any incision in the left or right ventricle or percutaneous ablation may also be the cause for ventricular arrhythmia. In this short review we will describe the most common underlying substrates for ventricular arrhythmia, indications for surgery, the techniques used for treatment and the results achieved. We will conclude that for most cases of patients with ventricular arrhythmia undergoing surgery, ischemia and the presence of a scar after myocardial infarction is the underlying cause and revascularization plus surgical ventricular reconstruction with endocardial resection may be the best treatment option.

Original languageEnglish
Pages (from-to)62-67
Number of pages6
JournalHerzschrittmachertherapie und Elektrophysiologie
Volume18
Issue number2
DOIs
Publication statusPublished - Jun 2007

Keywords

  • Ablation
  • Right ventricular dysplasia
  • Surgical ventricular reconstruction
  • Ventricular aneurysm
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Doenst, T., Faerber, G., Grandinac, S., Kuntze, T., Menicanti, L., Borger, M. A., & Mohr, F. W. (2007). Surgical therapy of ventricular arrhythmias. Herzschrittmachertherapie und Elektrophysiologie, 18(2), 62-67. https://doi.org/10.1007/s00399-007-0561-1