Surgery for postinfarction ventricular tachycardia in the pre-implantable cardioverter defibrillator era: early and long term outcomes in 100 consecutive patients

OBJECTIVE To report outcome following surgery for postinfarction ventricular tachycardia undertaken in patients before the use of implantable defibrillators. DESIGN A retrospective review, with uniform patient selection criteria and surgical and mapping strategy throughout. Complete follow up. Long term death notification by OPCS (Office of Population Censuses and Statistics) registration. SETTING Tertiary referral centre for arrhythmia management. PATIENTS 100 consecutive postinfarction patients who underwent map guided endocardial resection at this hospital in the period 1981–91 for drug refractory ventricular tachyarrhythmias. RESULTS Emergency surgery was required for intractable arrhythmias in 28 patients, and 32 had surgery within eight weeks of infarction (“early”). Surgery comprised endocardial resections in all, aneurysmectomy in 57, cryoablations in 26, and antiarrhythmic ventriculotomies in 11. Twenty five patients died