Yoshikawa Y, Taniguchi S, Kawata T, Hamada Y, Kawachi K, Kitamura S
Department of Surgery III, Nara Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1997 Aug;45(8):1122-6.
A 52-year-old man with reduced left ventricular function (ejection fraction 0.27) due to myocardial infarction, underwent coronary artery bypass grafting (CABG; LITA-LAD, free RITA-4PD) for angina pectoris. He had suffered from recurrent sustained ventricular tachycardia (VT) since 5 hours after CABG. This arrhythmia was resistant to various antiarrhythmic agents such as Lidocaine, Mexiletine, Disopyramide, Procainamide and Propafenone. He required mechanical circulatory supports (intra-aortic balloon pumping and percutaneous cardiopulmonary support) for the maintenance of hemodynamics during repeated VT that required cardioversions of a total of 441 times during 18 days. Following the administration of Amiodarone, the VT was successfully suppressed. However, he had repeated episodes of VT on exercise, thus, he underwent insertion of the implantable cardioverter-defibrillator at the 98 post-operative day, and he was successfully discharged at the 134 post-operative day after CABG. The instrument was verified to be normal in function after the VT induction test.
一名52岁男性因心肌梗死导致左心室功能减退（射血分数0.27），因心绞痛接受了冠状动脉旁路移植术（CABG；左内乳动脉-左前降支，游离右内乳动脉-第4钝缘支）。冠状动脉旁路移植术后5小时起，他就反复出现持续性室性心动过速（VT）。这种心律失常对利多卡因、美西律、丙吡胺、普鲁卡因胺和普罗帕酮等多种抗心律失常药物均耐药。在反复室性心动过速发作期间，为维持血流动力学，他需要机械循环支持（主动脉内球囊反搏和体外膜肺氧合），在18天内共进行了441次电复律。胺碘酮治疗后，室性心动过速成功得到抑制。然而，他运动时仍反复出现室性心动过速发作，因此，在术后第98天植入了植入式心律转复除颤器，冠状动脉旁路移植术后第134天成功出院。在进行室性心动过速诱发试验后，证实该器械功能正常。
