Curative surgical treatment of atrioventricular junctional re-entrant tachycardia by perinodal dissection
| Autor: | Thomsen Pe, Albrechtsen O, Peter Thomas Mortensen, Paulsen Pk |
|---|---|
| Rok vydání: | 1989 |
| Předmět: |
Pulmonary and Respiratory Medicine
Tachycardia Adult Male medicine.medical_specialty Bundle of His Adolescent Preoperative care Electrocardiography Heart Conduction System Internal medicine Preoperative Care medicine Tachycardia Supraventricular Humans Tachycardia Atrioventricular Nodal Reentry cardiovascular diseases Atrium (heart) Child Intraoperative Care medicine.diagnostic_test business.industry Cardiac Pacing Artificial General Medicine Middle Aged medicine.disease Atrioventricular node Surgery Electrophysiology medicine.anatomical_structure cardiovascular system Cardiology Atrioventricular Node Female Supraventricular tachycardia Electrical conduction system of the heart medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 3(5) |
| ISSN: | 1010-7940 |
| Popis: | The medical treatment of an atrioventricular junctional (AV-nodal) re-entrant tachycardia (AVJRT) is often ineffective due to failure of response or significant side effects. Recently, reports of curative surgical procedures using either dissection or cryocoagulation in the AV node area with preservation of normal AV conduction, have been published with excellent short term results in small series. The present paper describes our experience of surgical treatment using the dissection method in five patients. In all patients, AVJRT with short retrograde conduction intervals was diagnosed during the pre- and intraoperative electrophysiological studies. The earliest site of atrial activation during tachycardia was seen close to the triangle of Koch, antero-medially to the AV node. Elective open heart surgery was performed and after cold cardioplegic arrest, the right atrial endocardium was incised and the perinodal atrium carefully disconnected from the AV node. After surgery, a tachycardia could not be induced in any of the patients. In a follow-up period of 14-29 months, all patients have been free of symptoms without antiarrhythmic drugs. Early electrophysiological evaluation of patients with supraventricular tachycardia is advocated and in patients with medically refractory AVJRT, surgery is recommended. |
| Databáze: | OpenAIRE |
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