Cardiomyoplasty and implantable cardioverter defibrillator: Efficacy and safety of concomitant device implantation: Sudden death and cardiomyoplasty

Sudden death represents a common event in the natural history of patients a ffected by chronic heart failure. Such an outcome also has been shown to ch aracterize the follow-up of the cardiomyoplasty procedure. We report two ca ses of patients who had cardiomyoplasty and experienced witnessed episodes of ventricular arrhythmia at variable times after surgery (2 years and 2 mo nths, respectively). In the first case, an implantable cardioverter defibri llator (ICD) was implanted subsequent to the arrhythmic episode, whereas th e second patient had a combined cardiomyoplasty and ICD implantation proced ure. In particular, this patient underwent a modified wrapping technique, h erein described, because of a large left ventricular dilatation. In both ca ses, ventricular defibrillation did not affect the correct functioning of t he implanted cardiomyostimulator. Our article confirms that ventricular arr hythmia is common in cardiomyoplasty patients. The combined use of a skelet al muscle stimulator and implantable defibrillator may therefore be effecti ve in preventing arrhythmia-related sudden death without any concurrent eff ect on the correct functioning of the wrapped muscle/heart circuit, with li kely benefit on long-term cardiomyoplasty patient survival.