CORONARY-BYPASS SURGERY IN EXERCISE-INDUCED VENTRICULAR-TACHYCARDIA

Among 400 consecutive patients undergoing conventional isolated bypass surgery, 9 patients had clinical and electrocardiographic evidence of severe ischaemia during exercise and serious exercise-induced ventricular arrhythmias. Four patients had spontaneous exercise-induced arrhythmias and two had been resuscitated for out-of-hospital cardiac arrest. Postoperatively all patients were free of angina, off anti-anginal drugs with considerably increased exercise capacity and maximal heart rate during exercise. No spontaneous or exercise induced arrhythmias have recurred during observation periods ranging from one to four and a half years. In this subset of patients ischaemia seems to be the crucial arrhythmia-inducing factor and bypass surgery alone may therefore be therapeutic. The reduction of ischaemic exercise-induced arrhythmias may be one way by which bypass surgery reduces mortality in larger patient series. © 1987 The European Society of Cardiology.