Treatment of malignant ventricular arrhythmias with the automatic implantable cardioverter defibrillator

A. D. Slater, I. Singer, C. S. Stavens, C. Zee-Cheng, B. L. Ganzel, J. Kupersmith, C. Mavroudis, L. A. Gray

Research output: Contribution to journalArticlepeer-review

Abstract

Twenty-eight patients with malignant ventricular arrhythmias were treated with the automatic implantable cardioverter-defibrillator (AICD) in a 14-month period. Thirteen patients were resuscitated from a ventricular fibrillation (VF) episode. Fifteen patients presented with ventricular tachycardia (VT) refractory to medical therapy. The etiology was coronary artery disease in 23 of 28 patients (82%), dilated cardiomyopathy in 2 of 28 patients (7%), sarcoidosis in 2 of 28 patients, and 1 patient in 28 had lupus erythematosis. The mean left ventricular ejection fraction was 29%. A total of 27 of 28 patients (96%) patients had inducible ventricular tachycardia using programmed stimulation. The patients considered for AICD implant failed a mean of 3.6 antiarrhythmic drugs. Rate counting and defibrillating leads were inserted through a lateral thoracotomy in 17 patients and a mediansternotomy incision in 11 patients in conjunction with another cardiac procedure in 10 patients. The generators were positioned in a subcutaneous pocket beneath the left costal margin. There were no operative deaths. The mean follow-up was 6.7 months (range 1 to 14) with no VT/VF deaths in patients with defibrillators. The study demonstrated that AICD is an effective device for prevention of sudden cardiac death.

Original languageEnglish (US)
Pages (from-to)635-641
Number of pages7
JournalAnnals of surgery
Volume209
Issue number5
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Surgery

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