[Epicardial scintigraphy in 4 cases of ventricular tachycardia caused by reentry of blood after myocardial infarct. Origin of the tachycardia and surgical approach].

110 point cartography was carried out over the ventricular pericardium during sinus rhythm (SR) and during ventricular tachycardia (VT) in four patients whose infarctions were 15 days, 4 months, 4 years and 7 years previously, and in whom electrocardiographic investigation had suggested a ventricular reentry phenomenon. The macroscopical appearances of the heart at operation suggested that the infarct was situated along the left side in two cases, and in or along the septum in two others. Cartography in sinus rhythm showed that the onset of ventricular activity was compatable with a site of origin in the node/bundle of His. Cartography during VT showed up the epicentre of the abnormal impulses which were always situated outside the exit points and dependent upon the node/bundle of His system as demonstrated by cartography in sinus rhythm. Moreover, in at least two cases this was found to lie outside the infarcted area, in portions of the myocardium which could be considered as healthy. In one case it was found to lie along the anterior interventricular groove, facing the septal infarct. In two cases the arrhythmia will not recur, one having achieved this status bu simple ventriculotomy. The failures are reported in relation to the extent of the lesion anatomically, which may cause disorientation of the surgical approach, and make the results difficult to interpret.