The effect of myocardial revascularization on malignant ventricular arrhythmias in coronary artery disease.

Background: Malignant ventricular arrhythmia in coronary artery disease (CAD) is a severe life-threatening disease and a risk factor for sudden cardiac death. Myocardial revascularization influences the arrhythmogenic substrate of the malignant ventricular arrhythmia in the secondary prevention of sudden cardiac death. Its effectivity remains controversial.

Objectives: The aim of this study is to assess the inducibility of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients after myocardial revascularization and to compare the effectivity of complete and incomplete revascularization.

Patients: Fifty patients with documented sustained VT or VF and CAD were examined in our department.

Results: Conservatively treated patients were significantly older than revascularized patients (68 +/- 8 versus 62 +/- 9 years, p<0.05). We registered a trend towards a lower inducibility of malignant ventricular arrhythmias in the revascularized group and completely revascularized subgroup, but without statistical significance. Incompletely revascularized patients comprised only of men (100% versus 66.6%, p<0.05). Fewer ICDs were implanted in the completely revascularized group (55.6% versus 92.3%, p<0.05).

Conclusion: Myocardial revascularization has little effect on the inducibility of malignant ventricular arrhythmias after myocardial revascularization. Complete revascularization significantly decreases the need of ICD implantation when compared to incomplete one (Tab. 3, Fig. 4, Ref. 24). Full Text (Free, PDF) www.bmj.sk.