Map guided surgery for ventricular tachycardia

In II N.D. Cardiac Surgery Dept. 53 patients pts.with drug refractory, life -threatening arrhythmia VT were refereed for surgery. The majority of pts. had VT reliable to schematic heart disease. 31 pts has had at least one car diac arrest in mechanism of ventricular fibrillation in history. All pts ha d intraoperative computerised mapping from 56 electrodes in order to exact localisation the site of arrhythmia. As a result of preoperative in intraop erative investigation following procedures have been done. 1/ In 16 pts CABGr and aneurysmectomy was done. 2/ In 29 pts CABGr and Cryoablation was performed. 3/ In 7 patients Cryoablation of founded origin of arrhythmia was done. All pts had a control mapping after completing the procedure to confirm the effectiveness of ablation. 4 pts died postoperatively. 6 pts required IABP for poor left ventricular function. We conducted 1 to 3 years follow-up. I t was revealed that 36 patients were free of arrhythmia, and required no me dication. In 5 pts. VT post operatively reoccurred but was easier to contro l by drugs. 13 pts. required ICD implantation postoperatively due to ventri cular arrhythmia. The preliminary results are relatively good if consider that mean ejection fraction in this group was 31% (19-38%). In pts. with MD required CABGr and the history of cardiac arrest we considered surgery as a method of choice.