Clinical experience with fulguration and antiarrhythmic therapy for the treatment of ventricular tachycardia. Long-term follow-up of 43 patients.

Forty-three patients (mean age, 45 +/- 18 years) with drug-refractory VT of varied etiologies, including 15 cases occurring after chronic myocardial infarction, underwent fulguration procedures. With a mean follow-up of 29 +/- 12 months (range, 9 to 55 months), after one to four sessions, VT had been controlled without a need for antiarrhythmic drugs in 22 (56 percent) of the 39 patients surviving the perioperative period and was controlled in 17 patients (44 percent) with the help of drugs. No malignant arrhythmias were observed following fulguration. There were five early deaths, four deaths related to the procedure, and eight late deaths, but no death was thought to be related to the endocardial shock itself. Thus, fulguration appears to be a valuable adjunct to the treatment of drug-resistant VT.