Prevention of postsurgical atrial tachycardia with a modified right atrial free wall incision

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Gang YangMinglong Chen

Abstract

Most postsurgical macroreentry atrial tachycardias (PS-MATs) are atriotomy related; however, underlying mechanisms and prevention remain undefined. The purpose of the present study was to investigate the electrophysiological and histologic bases of right atriotomy incision arrhythmogenicity and whether a modified atriotomy that extends the incisional line to the tricuspid annulus (TA) and inferior vena cava (IVC) prevents PS-MAT. Atrial arrhythmia induction and electrophysiological and histologic characteristics were studied 8 weeks after right atriotomy in 30 adult swine according to incision distance to TA or IVC (groups A, B, and C: broad, narrow, and closed corridors, respectively; group D, no-incision sham; n = 6 per group, except n = 12 for group B). Sustained PS-MATs were induced and mapped in the broad- and narrow-corridor groups (A, 1 of 6 [16.7%] vs B, 5 of 12 [41.7%]) but not in the closed-corridor (C) or sham (D) groups (P = .087). With 20-ms pacing cycle-length decrements (from 350 to 270 ms), mean conduction time over 20 mm at the atriotomy-to-TA corridor was 29.2 ± 2.2, 31.0 ± 4.2, 26.0 ± 1.9, and 17.0 ± 1.4 ms for 5 and 10 mm (both group B), 15 mm (group A), and sham incision (P = .017), respectively. Conduction...Continue Reading

References

Aug 1, 1992·Journal of the American College of Cardiology·G K Feld, F Shahandeh-Rad
Dec 13, 1990·The New England Journal of Medicine·J G MurphyG K Danielson
Oct 1, 1985·Journal of the American College of Cardiology·A GarsonC J Porter
Jul 1, 1983·American Heart Journal·M T Bink-BoelkensR A Hardjowijono
May 1, 1996·The Annals of Thoracic Surgery·S K GandhiC B Huddleston
Jul 3, 1999·The Annals of Thoracic Surgery·R LeeJ L Cox
Feb 15, 2000·Circulation·D ShahM Haïssaguerre
Apr 16, 2003·Journal of Cardiovascular Electrophysiology·Ravi MandapatiJohn K Triedman
Jul 25, 2003·The Journal of Thoracic and Cardiovascular Surgery·Yosuke IshiiGoro Asano
Jul 21, 2004·Journal of the American College of Cardiology·Atul VermaAndrea Natale
Jul 30, 2005·Journal of Cardiovascular Electrophysiology·Isabelle Magnin-PoullEtienne Aliot

❮ Previous
Next ❯

Citations

Aug 12, 2015·Herzschrittmachertherapie & Elektrophysiologie·Thomas RostockCathrin Theis
Sep 14, 2017·Circulation. Arrhythmia and Electrophysiology·Elisabeth M J P Mouws, Natasja M S de Groot
Sep 14, 2017·Circulation. Arrhythmia and Electrophysiology·Pablo ÁvilaFrancisco Fernández-Avilés
Jul 2, 2019·Circulation·Jack RychikUNKNOWN American Heart Association Council on Cardiovascular Disease in the Young and Council on Cardiovascular and Stroke Nursing

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiac Conduction System

The cardiac conduction system is a specialized tract of myocardial cells responsible for maintaining normal cardiac rhythm. Discover the latest research on the cardiac conduction system here.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.