Abstract

In three patients with clinical ischemic heart disease ventricular tachycardia developed during standard exercise testing. Despite suppressive antiarrhythmic therapy, ventricular tachycardia during exercise persisted in one patient; ventricular fibrillation requiring cardiopulmonary resuscitation developed in the other two. Coronary angiography revealed significant obstructive coronary artery disease with no ventricular aneurysm in all three patients. Aortocoronary saphenous vein bypass surgery was performed successfully without electrocardiographic or clinical evidence of intraoperative myocardial infarction. Postoperative cineangiography documented graft patency, and repeated exercise testing failed to elicit any ventricular irritability in these patients. They have remained asymptomatic with no antiarrhythmic therapy for up to 2 years postoperatively.

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