TY - JOUR
T1 - De novo refractory ventricular tachyarrhythmias after coronary revascularization
AU - Topol, Eric J.
AU - Lerman, Bruce B.L.
AU - Baughman, Kenneth L.
AU - Platia, Edward V.
AU - Griffith, Lawrence S.C.
N1 - Funding Information:
From the Division of Cardiology, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore, Maryland. This work was supported by Ischemic SCOR Grant HL-1765547 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. Dr. Topol’s present address is Cardiac Study Unit, 55438 Main Hospital, The LJni-versity of Michigan Hospital, 1405 E. Ann Street, Ann Arbor, Michigan 48109. Manuscript received May 1,1985; revised manuscript received June 7.1985. accepted June 10,1985. Address for reprints: Bruce B. Lerman, MD, Division of Cardiology, University of Virginia Hospital, Box 158, Charlottesville, Virginia 22908.
PY - 1986/1/1
Y1 - 1986/1/1
N2 - Twelve of 1,675 patients who underwent coronary artery bypass grafting during a 2.5-year period had new onset, recurrent, sustained ventricular tachyarrhythmia a mean of 27 days (range 2 to 150) postoperatively. No patient had an Intra- or perioperative myocardial Infarction and all patients were hemodynamically stable and had normal metabolic and electrolytic indexes at the time of ventricular tachyarrhythmia. Preoperative ejection fraction was 39 ± 10% (mean ± standard deviation) and all patients had Lown grade II or less ventricular ectopic activity on ambulatory monitoring. Postoperative angiography demonstrated occluded saphenous vein grafts In 3 of 7 patients studied, none of whom had symptoms suggestive of myocardial ischemia. Treatment with conventional antlarrhythmic therapy was unsuccessful in all but 1 patient, and 10 patients were treated with amiodarone and 1 patient with propafenons. Four of these patients also received an automatic implantable defibrillator. Thus, de novo ventricular tachyarrhythmia can occur unexpectedly after coronary artery bypass grafting and may be the result of several factors related to either subclinical graft occlusion or increased dispersion of repolarization secondary to reperfusion.
AB - Twelve of 1,675 patients who underwent coronary artery bypass grafting during a 2.5-year period had new onset, recurrent, sustained ventricular tachyarrhythmia a mean of 27 days (range 2 to 150) postoperatively. No patient had an Intra- or perioperative myocardial Infarction and all patients were hemodynamically stable and had normal metabolic and electrolytic indexes at the time of ventricular tachyarrhythmia. Preoperative ejection fraction was 39 ± 10% (mean ± standard deviation) and all patients had Lown grade II or less ventricular ectopic activity on ambulatory monitoring. Postoperative angiography demonstrated occluded saphenous vein grafts In 3 of 7 patients studied, none of whom had symptoms suggestive of myocardial ischemia. Treatment with conventional antlarrhythmic therapy was unsuccessful in all but 1 patient, and 10 patients were treated with amiodarone and 1 patient with propafenons. Four of these patients also received an automatic implantable defibrillator. Thus, de novo ventricular tachyarrhythmia can occur unexpectedly after coronary artery bypass grafting and may be the result of several factors related to either subclinical graft occlusion or increased dispersion of repolarization secondary to reperfusion.
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U2 - 10.1016/0002-9149(86)90951-3
DO - 10.1016/0002-9149(86)90951-3
M3 - Article
C2 - 3484603
AN - SCOPUS:0022655388
SN - 0002-9149
VL - 57
SP - 57
EP - 59
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 1
ER -