Left atrial isolation. New technique for the treatment of supraventricular arrhythmias

J. M. Williams, R. M. Ungerleider, G. K. Lofland, James Lewis Cox

Research output: Contribution to journalArticle

190 Citations (Scopus)

Abstract

Surgical management of refractory ectopic supraventricular tachycardia arising in the left atrium requires cryoablation of the bundle of His and insertion of a permanent ventricular pacemaker. This study was designed to develop a technique to isolate the left atrium electrically from the remainder of the heart, so that an artificial pacemaking system would be unnecessary. Ten adult dogs were subjected to cardiopulmonary bypass and a standard left atriotomy was extended anteriorly across the mitral valve anulus between the right and left fibrous trigones. Posteriorly, the atriotomy was extended across the mitral valve annulus just to the left of the posterior crux and interatrial septum. The muscular interatrial fibers accompanying the coronary sinus were cryoblated at -60°C for 2 minutes. Postoperatively, all animals remained in normal sinus rhythm. Rapid left atrial pacing did not affect the rate or rhythm of the remainder of the heart. Preliminary hemodynamic measurements suggest that loss of the synchronous left atrial 'kick' does not significantly affect left ventricular preload, afterload, or cardiac output. This technique offers an alternative to the current surgical approach for management of refractory ectopic supraventricular tachycardia arising in the left atrium.

Original languageEnglish (US)
Pages (from-to)373-380
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume80
Issue number3
StatePublished - Dec 1 1980

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Heart Atria
Cardiac Arrhythmias
Supraventricular Tachycardia
Mitral Valve
Artificial Heart
Bundle of His
Cryosurgery
Coronary Sinus
Cardiopulmonary Bypass
Cardiac Output
Hemodynamics
Dogs

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "Surgical management of refractory ectopic supraventricular tachycardia arising in the left atrium requires cryoablation of the bundle of His and insertion of a permanent ventricular pacemaker. This study was designed to develop a technique to isolate the left atrium electrically from the remainder of the heart, so that an artificial pacemaking system would be unnecessary. Ten adult dogs were subjected to cardiopulmonary bypass and a standard left atriotomy was extended anteriorly across the mitral valve anulus between the right and left fibrous trigones. Posteriorly, the atriotomy was extended across the mitral valve annulus just to the left of the posterior crux and interatrial septum. The muscular interatrial fibers accompanying the coronary sinus were cryoblated at -60°C for 2 minutes. Postoperatively, all animals remained in normal sinus rhythm. Rapid left atrial pacing did not affect the rate or rhythm of the remainder of the heart. Preliminary hemodynamic measurements suggest that loss of the synchronous left atrial 'kick' does not significantly affect left ventricular preload, afterload, or cardiac output. This technique offers an alternative to the current surgical approach for management of refractory ectopic supraventricular tachycardia arising in the left atrium.",
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Left atrial isolation. New technique for the treatment of supraventricular arrhythmias. / Williams, J. M.; Ungerleider, R. M.; Lofland, G. K.; Cox, James Lewis.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 80, No. 3, 01.12.1980, p. 373-380.

Research output: Contribution to journalArticle

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