The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 261-265, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Surgical treatment of symptomatic, drug-resistant ventricular bigeminy and other forms of complex ventricular ectopy (ventricular allorhythmias)
LA Bockeria, AS Revishvili and EZ Goluchova
Department of the Arrhythmias, A.N. Bakulev Institute of Cardiovascular Surgery, Moscow, U.S.S.R.
This article describes 18 patients with drug-resistant ventricular bigeminy
and other forms of complex ventricular ectopy (allorhythmias) associated
with recurrent syncope. Particular emphasis is placed on the
electrophysiologic methods used to characterize the basis of these
arrhythmias and to accomplish isochronous mapping to identify their site of
origin. A malignant course of drug-resistant bigeminy in combination with
other rhythm disorders was accepted as indications for surgical
intervention. Cryosurgery was the method used most frequently for the
ablation of arrhythmogenic myocardium. All 18 patients underwent
postoperative electrophysiologic studies and Holter monitoring to determine
the efficacy of the operation. Fifteen of the 18 patients were cured of
their symptomatic arrhythmia. Thus surgical intervention is an effective
method for the treatment of patients with symptomatic, drug-resistant
ventricular allorhythmias.
