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Right ventricular isolation procedures for nonischemic ventricular tachycardia.

Publication ,  Journal Article
Cox, JL; Bardy, GH; Damiano, RJ; German, LD; Fedor, JM; Kisslo, JA; Packer, DL; Gallagher, JJ
Published in: J Thorac Cardiovasc Surg
August 1985

Nonischemic ventricular tachycardia most commonly arises in the right ventricular free wall and is frequently refractory to medical therapy. Many different types of surgical procedures have been employed to treat medically refractory nonischemic ventricular tachycardia arising in the right ventricle, but the results of these procedures have been less than optimal. The majority of these surgical procedures have been directed toward ablation of the site (or sites) of origin of the tachyarrhythmia and have failed because of the frequent occurrence of multifocal or polymorphic ventricular tachycardia in these patients. We first employed localized surgical isolation procedures to control nonischemic ventricular tachycardia arising in the right ventricular free wall in 1979. These localized procedures evolved into the development of a technique for isolating the entire right ventricular free wall from the remainder of the heart to control ventricular tachyarrhythmias arising from multiple sites in the right ventricle. Case histories are reported of two patients who underwent localized isolation procedures in 1979 as well as two patients who underwent total disconnection of the right ventricle in 1982. The follow-up period in these four patients ranges from 2 to 5 years and the control of their tachyarrhythmias has been uniformly successful. However, surgical isolation of the entire right ventricular free wall has resulted in progressive dilatation of the right ventricle as documented by serial echocardiography. The pathophysiology of the progressive right ventricular dilatation postoperatively is discussed in terms of etiology and prevention, and the indications for application of localized and total isolation procedures for nonischemic right ventricular tachycardia are outlined.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

ISSN

0022-5223

Publication Date

August 1985

Volume

90

Issue

2

Start / End Page

212 / 224

Location

United States

Related Subject Headings

  • Tachycardia
  • Respiratory System
  • Recurrence
  • Radionuclide Imaging
  • Postoperative Complications
  • Methods
  • Male
  • Humans
  • Hemodynamics
  • Heart Ventricles
 

Citation

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Cox, J. L., Bardy, G. H., Damiano, R. J., German, L. D., Fedor, J. M., Kisslo, J. A., … Gallagher, J. J. (1985). Right ventricular isolation procedures for nonischemic ventricular tachycardia. J Thorac Cardiovasc Surg, 90(2), 212–224.
Cox, J. L., G. H. Bardy, R. J. Damiano, L. D. German, J. M. Fedor, J. A. Kisslo, D. L. Packer, and J. J. Gallagher. “Right ventricular isolation procedures for nonischemic ventricular tachycardia.J Thorac Cardiovasc Surg 90, no. 2 (August 1985): 212–24.
Cox JL, Bardy GH, Damiano RJ, German LD, Fedor JM, Kisslo JA, et al. Right ventricular isolation procedures for nonischemic ventricular tachycardia. J Thorac Cardiovasc Surg. 1985 Aug;90(2):212–24.
Cox, J. L., et al. “Right ventricular isolation procedures for nonischemic ventricular tachycardia.J Thorac Cardiovasc Surg, vol. 90, no. 2, Aug. 1985, pp. 212–24.
Cox JL, Bardy GH, Damiano RJ, German LD, Fedor JM, Kisslo JA, Packer DL, Gallagher JJ. Right ventricular isolation procedures for nonischemic ventricular tachycardia. J Thorac Cardiovasc Surg. 1985 Aug;90(2):212–224.
Journal cover image

Published In

J Thorac Cardiovasc Surg

ISSN

0022-5223

Publication Date

August 1985

Volume

90

Issue

2

Start / End Page

212 / 224

Location

United States

Related Subject Headings

  • Tachycardia
  • Respiratory System
  • Recurrence
  • Radionuclide Imaging
  • Postoperative Complications
  • Methods
  • Male
  • Humans
  • Hemodynamics
  • Heart Ventricles