Abstract
Analyses of 75 surgically treated patients for potential life-threatening ven tricular tachyarrhythmias demonstrate a distinct subset of patients with "nor mal" coronary ventricular tachyarrhythmias. This subset of 10 patients (Group A) was compared with the remaining 65 patients (Group B), who had intra luminally obstructed and ischemic lesions. The etiologies for Group A patients included 4 hypertrophic cardiomyopathies, 4 dynamic intramyocardial muscle bridges, and 2 congenital aneurysms or diverticula. The localized arrhythmic foci for Group A were all preoperatively or intraoperatively determined as com pared with only 33 of 65 (51 %, p < 0.05) in Group B. While the specific types of surgical intervention for the two groups were seemingly identical (ie, revascu larization, endocardial resection, aneurysmectomy and reconstruction, and/or insertion of automatic internal cardiac defibrillators), the mortality rates were significantly different (mortality A vs B: early 0/10 vs 5/65, p < 0.05 and late 0/ 10 vs 4/60, p < 0.05). All Group A patients underwent repeated studies demon strating maintained ventricular function, in contrast to Group B patients, who exhibited severe ventricular impairment (7/60, p < 0.05).
In summary, "normal" coronary ventricular tachyarrhythmias are found in a distinctive subset of patients. Their different etiologies result in better out comes from direct operation, and hence, these patients should be managed with this important premise. Indirect or non-operative approaches should not be used in place of these potential cures.
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