Document Detail


The effect of coronary bypass graft surgery for the prevention of sudden cardiac death: recurrent episodes after ICD implantation and review of literature.
MedLine Citation:
PMID:  7513886     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sudden cardiac death (SCD) accounts for at least 50% of the mortality of patients with ischemic heart failure. Ventricular arrhythmias are responsible for most cases of sudden cardiac death. There is some evidence that coronary artery bypass graft (CABG) surgery may reduce the incidence of recurrent episodes of SCD by prevention of myocardial ischemia. To test the hypothesis that CABG surgery is effective in the prevention of SCD, we compared the recordings of implantable cardioverter defibrillators (ICD) in patients who underwent ICD implantation alone (n = 64) or ICD implantation and concomitant CABG surgery respectively (n = 11). All patients had experienced out of hospital cardiac arrest. ICD recordings were obtained every 3 months and the number of recurrent episodes of ventricular tachycardia (VT) for each time period was noted. Three months following ICD implantation patients in the surgically treated group had an average of one episode of VT per patient as compared to 2.7 episodes in the nonsurgical group. This difference was observed during the following months as well. However, at no time (up to 18 months of follow-up) this difference reached statistical significance. There were no deaths in the surgically treated group. Although we could not demonstrate a statistical significant difference between the two groups, there was a tendency in the surgically treated group to have less episodes of recurrent VT than in the medically treated group. We, therefore, conclude that survivors of SCD presenting with multivessel coronary artery disease (CAD) should undergo coronary artery bypass grafting to prevent myocardial ischemia as the triggering event for lethal ventricular arrhythmias.
Authors:
R Autschbach; V Falk; B D Gonska; H Dalichau
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  17     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-06-09     Completed Date:  1994-06-09     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  552-8     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Georg-August-Universität Göttingen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass*
Coronary Disease / surgery*
Death, Sudden, Cardiac / prevention & control*
Defibrillators, Implantable*
Female
Follow-Up Studies
Heart Arrest / prevention & control
Humans
Male
Middle Aged
Myocardial Ischemia / prevention & control
Recurrence
Survival Rate
Tachycardia, Ventricular / prevention & control*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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