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
Oct 1, 1992·Circulation·G K FeldM Ibarra
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
Feb 1, 1996·Circulation·J M KalmanM D Lesh
May 1, 1996·The Annals of Thoracic Surgery·S K GandhiC B Huddleston
Oct 8, 1997·Journal of the American College of Cardiology·J K TriedmanE P Walsh
Jul 3, 1999·The Annals of Thoracic Surgery·R LeeJ L Cox
Feb 15, 2000·Circulation·D ShahM Haïssaguerre
Sep 12, 2000·Circulation·D P ChanA L Waldo
Feb 7, 2001·Circulation·H NakagawaW M Jackman
Feb 22, 2001·Circulation·Y TomitaA L Waldo
Apr 25, 2001·Circulation·J K TriedmanE P Walsh
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
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Peter LukacPeter S Hansen
Jul 30, 2005·Journal of Cardiovascular Electrophysiology·Isabelle Magnin-PoullEtienne Aliot
Aug 14, 2012·Journal of Cardiovascular Electrophysiology·Bing YangMinglong Chen
Citations
Jan 1, 2016·International Journal of Cardiology·Gong-Bu ZhouShu Zhang
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
Jul 10, 2020·Pediatric Cardiology·He JiangMei-Ting Li
Nov 5, 2020·PloS One·Chanhee SeoDarryl R Davis