Surgical alternatives for supraventricular tachycardias.
Identifieur interne : 001B63 ( Ncbi/Curation ); précédent : 001B62; suivant : 001B64Surgical alternatives for supraventricular tachycardias.
Auteurs : G M Guiraudon [Canada] ; G J Klein ; A D Sharma ; R. YeeSource :
- The American journal of cardiology [ 0002-9149 ] ; 1989.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Atrial Fibrillation (physiopathology), Atrial Fibrillation (surgery), Atrial Flutter (physiopathology), Atrial Flutter (surgery), Child, Child, Preschool, Echocardiography, Electrophysiology, Female, Humans, Infant, Male, Middle Aged, Recurrence, Reoperation, Tachycardia, Atrioventricular Nodal Reentry (physiopathology), Tachycardia, Atrioventricular Nodal Reentry (surgery), Tachycardia, Supraventricular (surgery), Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (surgery).
- MESH :
- physiopathology : Atrial Fibrillation, Atrial Flutter, Tachycardia, Atrioventricular Nodal Reentry, Wolff-Parkinson-White Syndrome.
- surgery : Atrial Fibrillation, Atrial Flutter, Tachycardia, Atrioventricular Nodal Reentry, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome.
- Adolescent, Adult, Aged, Child, Child, Preschool, Echocardiography, Electrophysiology, Female, Humans, Infant, Male, Middle Aged, Recurrence, Reoperation.
Abstract
Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electrophysiologic interventions have been developed for all supraventricular arrhythmias. The surgical rationales are based on the site of origin of the arrhythmic mechanism and the associated pathology that characterizes the "arrhythmogenic substrate." The Wolff-Parkinson-White syndrome is characterized by an accessory atrioventricular (AV) connection distinct from the AV node-His bundle system. It is associated with AV reentrant tachycardia or atrial fibrillation, or both, with fast ventricular responses through the accessory pathway. The current surgical management involves ablation of the accessory pathway using either an endocardial or an epicardial approach. Surgical ablation is associated with high efficiency and low morbidity. Epicardial dissection of the accessory pathway on the beating heart has helped to localize variant accessory pathways associated with Coumel's tachycardia or the Mahaim fiber. AV nodal reentrant tachycardia can be cured using direct AV nodal dissection (or perinodal cryoablation). Atrial flutter can be interrupted by cryoablation of the arrhythmogenic substrate located in the coronary sinus orifice region. The chronotropic atrial function, abolished by incessant or paroxysmal idiopathic atrial fibrillation, can be restored using the corridor operation (sinus node-AV node insulation). The success of surgical intervention in atrial tachycardias is uncertain, but it may be an option in selected patients with resistant atrial tachycardias.
PubMed: 2596418
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Yee</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1989">1989</date><idno type="RBID">pubmed:2596418</idno><idno type="pmid">2596418</idno><idno type="wicri:Area/PubMed/Corpus">001C04</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001C04</idno><idno type="wicri:Area/PubMed/Curation">001C04</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001C04</idno><idno type="wicri:Area/PubMed/Checkpoint">001C04</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001C04</idno><idno type="wicri:Area/Ncbi/Merge">001B63</idno><idno type="wicri:Area/Ncbi/Curation">001B63</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Surgical alternatives for supraventricular tachycardias.</title><author><name sortKey="Guiraudon, G M" sort="Guiraudon, G M" uniqKey="Guiraudon G" first="G M" last="Guiraudon">G M Guiraudon</name><affiliation wicri:level="3"><nlm:affiliation>Department of Surgery, University of Western Ontario, University Hospital, London, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Surgery, University of Western Ontario, University Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Klein, G J" sort="Klein, G J" uniqKey="Klein G" first="G J" last="Klein">G J Klein</name></author><author><name sortKey="Sharma, A D" sort="Sharma, A D" uniqKey="Sharma A" first="A D" last="Sharma">A D Sharma</name></author><author><name sortKey="Yee, R" sort="Yee, R" uniqKey="Yee R" first="R" last="Yee">R. Yee</name></author></analytic><series><title level="j">The American journal of cardiology</title><idno type="ISSN">0002-9149</idno><imprint><date when="1989" type="published">1989</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Atrial Fibrillation (physiopathology)</term><term>Atrial Fibrillation (surgery)</term><term>Atrial Flutter (physiopathology)</term><term>Atrial Flutter (surgery)</term><term>Child</term><term>Child, Preschool</term><term>Echocardiography</term><term>Electrophysiology</term><term>Female</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Recurrence</term><term>Reoperation</term><term>Tachycardia, Atrioventricular Nodal Reentry (physiopathology)</term><term>Tachycardia, Atrioventricular Nodal Reentry (surgery)</term><term>Tachycardia, Supraventricular (surgery)</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term><term>Wolff-Parkinson-White Syndrome (surgery)</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Atrial Fibrillation</term><term>Atrial Flutter</term><term>Tachycardia, Atrioventricular Nodal Reentry</term><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Atrial Fibrillation</term><term>Atrial Flutter</term><term>Tachycardia, Atrioventricular Nodal Reentry</term><term>Tachycardia, Supraventricular</term><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Echocardiography</term><term>Electrophysiology</term><term>Female</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Recurrence</term><term>Reoperation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electrophysiologic interventions have been developed for all supraventricular arrhythmias. The surgical rationales are based on the site of origin of the arrhythmic mechanism and the associated pathology that characterizes the "arrhythmogenic substrate." The Wolff-Parkinson-White syndrome is characterized by an accessory atrioventricular (AV) connection distinct from the AV node-His bundle system. It is associated with AV reentrant tachycardia or atrial fibrillation, or both, with fast ventricular responses through the accessory pathway. The current surgical management involves ablation of the accessory pathway using either an endocardial or an epicardial approach. Surgical ablation is associated with high efficiency and low morbidity. Epicardial dissection of the accessory pathway on the beating heart has helped to localize variant accessory pathways associated with Coumel's tachycardia or the Mahaim fiber. AV nodal reentrant tachycardia can be cured using direct AV nodal dissection (or perinodal cryoablation). Atrial flutter can be interrupted by cryoablation of the arrhythmogenic substrate located in the coronary sinus orifice region. The chronotropic atrial function, abolished by incessant or paroxysmal idiopathic atrial fibrillation, can be restored using the corridor operation (sinus node-AV node insulation). The success of surgical intervention in atrial tachycardias is uncertain, but it may be an option in selected patients with resistant atrial tachycardias.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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