P.3. Basic Science, Sudden Death Risk Stratification and Ventricular Arrhythmias: P.3.24 Surgical Treatment of Ventricular Arrhythmias in Coronary Artery Disease Patients. Long-term Follow-up Analysis

to assess results of combined surgical treatment of ventricular arrhythmias (VA) in coronary artery disease (CAD) patients undergoing surgical myocardial revascularization.

From 1988 to 2002, 154 patients (98% men, 2% women, mean age 49±8.2 years) underwent combined and isolated surgical repair of CAD and VA. 28% patients were in NYHA II, 54% - in NYHA III and 18% - in NYHA IV before surgery. 85% had a history of myocardial infarction (MI). Mean left ventricular (LV) ejection fraction (EF) was 35.3%. Preoperative examination included all noninvasive and invasive diagnostic methods.

Most significant prognostic factors of postoperative mortality were age>60 years, history of more than 1 MI, LV EF<40%, NYHA III-IV, presence of ventricular late potentials, abnormalities in heart rate variability, LV aneurysm type and location.

Patients with coronary artery disease and VA need simultaneous correction of arrhythmogenic substrate and myocardial revascularization. Performance of extended endocardial resection and cryodestruction of arrhythmogenic focus improves long-term follow- up results (p<0.05). Survival of patients with LV aneurysm in postoperative period depends on revascularization of symptom-dependent artery, regardless of its inclusion in infarcted process.