Author + information
- Received May 8, 1991
- Revision received October 30, 1991
- Accepted November 7, 1991
- Published online April 1, 1992.
- Kishore Nimkhedkar, MD,
- Colin J. Hilton, MB, FRCS,
- Stephen S. Furniss, MB, MRCP,
- John P. Bourke, MB, MRCP,
- Brian Glenville, MD, FRCS,
- Janet M. McComb, MD, MRCP and
- Ronald W.F. Campbell, MB, FRCP∗
- ↵∗Address for reprints: R. W. F. Campbell, MB, FRCP, University Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, England.
Ten patients (nine men, one woman; mean age 39 years) with arrhythmogenic right ventricular dysplasia underwent surgery to control life-threatening drug refractory ventricular arrhythmias. All had ventricular tachycardia causing syncope and six had a history of cardiac arrest. In all a minimum of three antiarrhythmic drugs (mean five) had been ineffective. At operation, the right ventricle was grossly diseased in all patients. Ventricular tachycardias were induced and mapped intraoperatively in all patients.
The surgical plan was to ablate the arrhythmogenic focus if it was < 4 cm2; one patient was so managed. Of the remaining nine, four underwent partial (approximately 40% of the right ventricular free wall) and five underwent tolal right ventricular disarticulation. All survived the operation and are alive at a mean follow-up interval of 24 months (range 5 to 67). Two patients developed new sustained ventricular tachycardias. These were well tolerated and, unlike the original arrhythmias, were easily controlled by drug treatment.
All patients who underwent right ventricular disarticulation manifested signs of right heart failure in the early postoperative period, but these lessened progressively with the development of systolic septal movement into the right ventricular cavity. All 10 patients are in New York Heart Association class I or II at last review.
In selected patients with arrhythmogenic right ventricular dysplasia, surgery offers a curative treatment for ventricular tachycardia and should be considered for patients whose arrhythmias are life-threatening and refractory to drug treatment.
☆ This work was supported by the British Heart Foundation London, England.
- Received May 8, 1991.
- Revision received October 30, 1991.
- Accepted November 7, 1991.