Arhythmia, CHF and Batista procedure

Posted By Michael Stusiak on February 17, 1999 at 16:17:34:







I am a 41 year old male with CHF, which the doctors believe derived from viral cardiomyopathy, onset in spring 1997.  Althogu fairly stable and functional on medication (coreg, lasix, zestril, k-dur, digoxin and coumadin), my left ventrical is severely dilated.  With a move to a new area and linking up with a new cardiologist, I have learned more about my condition.  Specifically, although I have known about the risk of progressive deterioration, I now am more aware of the sudden cardiac death risk from arythmia.  We had discussed my joining the scud-hft trial, but the transplant surgeon is concerned that the amniodaron (sp?) prong might be problematic given my elegibility for a transplant and the potential side effects of that drug. Other than CHF, I am in great health and have passed some of the objective tests as to general health and eligibility for transplant
I have discussed the Batista procedure with my cardiologist and the transplant surgeon, and the surgeon's understanding is that the outcomes in terms of mortality rates and patient profiles are not pinned down sufficiently yet to compare conventional transplant vs. surgical remodeling results and mortality (which is confirmed by at least a little of what I have read here).  My questions, though, are whether the Batista procedure alleviates the nerve damage that may be linked sudden cardiac death through arythmia? In other words, does the procedure have the potential for mechanically improving cardiac performance but not to reverse the risk of sudden cardiac death?  Are there any studies that have defined mortality risks from sudden cardiac death (as opposed to progressive failure), with or without any differentiation for size of enlargment, age, gender, EF or other objective indices?  Finally, I understand that arythmia leading to sudden cardiac death is somewhat idiosyncratic, i.e., not related to specific activity (rest or exercion); Is that the present understanding?  
Thanks so much for this service!