Survival after More than 700 DC Shocks Post-Coronary Artery Bypass Grafting: A Case Report

Introduction

Transient ventricular arrhythmia can occur after recent cardiac surgery, but it does not adversely influence the long-term outcome [[1], [2]]. Ventricular tachycardia (VT) can happen unexpectedly after coronary artery bypass grafting (CABG) and may be the result of several factors related to either subclinical graft occlusion or increased dispersion of repolarization secondary to reperfusion [[3]]. We present an unusually high-frequency recurrent VT/ventricular fibrillation (VF) (700 episodes) after CABG.

References

• 1 Smith R C, Leung J M, Keith F M. et al . Ventricular dysrhythmias in patients undergoing coronary artery bypass graft surgery: incidence, characteristics, and prognostic importance.  Am Heart J. 1992;  123 73-81
• 2 Brembilla-Perrot B, Villemot J P, Carteaux J P. et al . Postoperative ventricular arrhythmias after cardiac surgery: immediate- and long-term significance.  Pacing Clin Electrophysiol. 2003;  26 619-625
• 3 Topol E J, Lerman B B, Baughman K L. et al . De novo refractory ventricular tachyarrhythmias after coronary revascularization.  Am J Cardiol. 1998;  57 57-59
• 4 Sarkozy A, Doria P. Strategies for reversing shock-resistant ventricular fibrillation.  Curr Opin Crit. 2003;  9 189-193
• 5 Eisenberg M S, Mengert T J. Cardiac resuscitation.  N Engl J Med. 2001;  344 1304-1313
• 6 Wetstein L, Michelson E L, Moore E N. et al . Surgical therapy for ventricular tachyarrhythmias.  Surg Gynecol Obstet. 1983;  157 487-496
• 7 Murry C E, Jennings R B, Reimer K A. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium.  Circulation. 1986;  74 1124-1136
• 8 Bolli R. The last phase of preconditioning.  Circulation Res. 2000;  87 972-983
• 9 Drysdale E, Grubb N, Fox K, O'Carroll R. Chronicity of memory impairment in long-term out-of-hospital cardiac arrest survivors.  Resuscitation. 2000;  47 27-32
• 10 O'Reilly S M, Grubb N R, O'Carroll R E. In-hospital cardiac arrest leads to chronic memory impairment.  Resuscitation. 2003;  58 1 73-79
• 11 Stuber T, Eigenmann C, Delacretaz E. Characteristics and relevance of clustering ventricular arrhythmias in defibrillator recipients.  Pacing Clin Electrophysiol. 2005;  28 702-707