| Title | Impending sudden cardiac death: treatment with myocardial revascularization and the automatic implantable cardioverter defibrillator. | | Author(s) | Fonger JD, Guarnieri T, Griffith LS, Veltri E, Levine J, Mower M, Mirowski M, Grunwald L, Watkins L | | Institution | Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD. | | Source | Ann Thorac Surg 1988 Jul; 46(1):13-9. | | MeSH | Adult
Aged
Arrhythmia
Combined Modality Therapy
Coronary Disease
Death, Sudden
Electric Countershock
Electrocardiography
Female
Follow-Up Studies
Heart Arrest
Humans
Male
Middle Aged
Monitoring, Physiologic
Myocardial Revascularization
| | Abstract | Myocardial revascularization and implantation of the automatic implantable cardioverter defibrillator (AICD) have individually been shown to improve survival in patients after sudden cardiac death. Their combined role has not been well defined. Twenty-three survivors of sudden death underwent revascularization and AICD implantation at an average age of 59 years. The initial arrest was caused by ventricular fibrillation in 15 and ventricular tachycardia in 8. Exercise stress tests, ambulatory ECGs, and electrophysiological monitoring with programmed electrical stimulation were done preoperatively and postoperatively. Follow-up averaged 24 months with a two-year survival of 91%. Eight patients (35%) required AICD resuscitation an average of 8 months postoperatively, and electrophysiological testing did not accurately predict arrhythmia recurrence. The addition of AICD implantation to revascularization substantially improves survival of patients with sudden cardiac death. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 3382280 |
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