Electrophysiologically Guided Pre-operative Amiodarone Therapy in Dor Surgery

摘要

The Dor procedure of LV patch plasty (for left ventricular aneurysm) during CABG is associated with a very stormy postoperative course in some. Preoperative EPS was done to identify inducible arrhythmias, for prophylactic antiarrhythmic therapy. Eleven patients (Group I, n=11) were studied by PES in the RA and RV (2 sites) and burst pacing with and without Isoprenaline to induce arrhythmias. All patients with inducible arrhythmias were put on Amiodarone. These were compared with a group (Group II, n=15) who had no EP and went for Dor without Amiodarone. Six patients of group I had no inducible arrhythmias, 2 had NS VT, 2 had S VT (AVNRT & Atrial Tachy) and one had VF requiring DC shock. This group had no significant arrhythmias postoperatively. Group II had two patients with VF requiring cardioversion and three patients who had SVT managed with amiodarone and overdrive pacing. Patients with LV Dysfunction scheduled to undergo LV plasty procedures have a smoother postoperative course with EP guided therapy.