Harken A H, Horowitz L N, Josephson M E
Ann Thorac Surg. 1980 Nov;30(5):499-508. doi: 10.1016/s0003-4975(10)61306-9.
Recurrent ventricular tachycardia is a well-recognized complication of ischemic heart disease. Coronary bypass operation with or without aneurysmectomy has been disappointing as therapy for these arrhythmias. With the advent of programmed electrical stimulation, it has become possible to distinguish automatic and reentrant ventricular tachyarrhythmias. The latter have recently proved amenable to operative intervention. This review examines the pathophysiology and diagnosis of ventricular tachycardia using programmed electrical stimulation. Surgical therapy with resection, revascularization, autonomic modulation, thermal ablation, cardiac pacing, reentrant circuit interruption, and endocardial excision is explored. Operation for cardiac arrhythmias is on a firm electrophysiological foundation. Surgical treatment of refractory ventricular tachyarrhythmias is now rational, recommended, and rewarding.
反复性室性心动过速是缺血性心脏病一种公认的并发症。无论是否进行动脉瘤切除术，冠状动脉搭桥手术作为这些心律失常的治疗方法都不尽人意。随着程控电刺激技术的出现，区分自律性和折返性室性心律失常成为可能。最近已证明后者可通过手术干预治疗。本综述利用程控电刺激研究室性心动过速的病理生理学和诊断。探讨了采用切除、血运重建、自主神经调节、热消融、心脏起搏、折返环路中断及心内膜切除的手术治疗方法。心律失常的手术治疗有坚实的电生理基础。难治性室性心律失常的外科治疗目前是合理的、推荐的且效果良好的。
