Nonpharmacologic treatment of supraventricular tachycardia
Identifieur interne : 000454 ( Main/Corpus ); précédent : 000453; suivant : 000455Nonpharmacologic treatment of supraventricular tachycardia
Auteurs : Eric N. Prystowsky ; Douglas PackerSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1988.
Abstract
During the last 2 decades, more than 1,000 patients have undergone surgical division of an accessory pathway; many refinements in epicardial mapping and surgical techniques have been made. In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to <5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. Whereas our current thought is that surgery should be limited to those adults who fail to respond to pharmacologie therapy, advances in atrial endocardial and epicardial mapping, as well as surgical techniques, may expand the role of surgery in the treatment of ectopic atrial tachycardia.
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DOI: 10.1016/0002-9149(88)90021-5
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In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to <5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. Whereas our current thought is that surgery should be limited to those adults who fail to respond to pharmacologie therapy, advances in atrial endocardial and epicardial mapping, as well as surgical techniques, may expand the role of surgery in the treatment of ectopic atrial tachycardia.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Eric N. Prystowsky MD</name><affiliations><json:string>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</json:string></affiliations></json:item><json:item><name>Douglas Packer MD</name><affiliations><json:string>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</json:string></affiliations></json:item></author><articleId><json:string>88900215</json:string></articleId><language><json:string>eng</json:string></language><abstract>During the last 2 decades, more than 1,000 patients have undergone surgical division of an accessory pathway; many refinements in epicardial mapping and surgical techniques have been made. In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to >5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. 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Prystowsky, MD, Northside Cardiology, PC, 8402 Harcourt Road, Indianapolis, Indiana 46260.</note><affiliation>Address for reprints: Eric N. Prystowsky, MD, Northside Cardiology, PC, 8402 Harcourt Road, Indianapolis, Indiana 46260.</affiliation><affiliation>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</affiliation></author><author><persName><forename type="first">Douglas</forename><surname>Packer</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0642-X</idno><meeting><addName>A Symposium: The Use of Encainide in Supraventricular Tachycardias, Bermuda</addName><date>19880603</date><date>19880604</date></meeting><editor><persName>Gerald V. Naccarelli</persName></editor><editor><persName>MD</persName></editor><editor><persName>Hein J.J. Wellens</persName></editor><editor><persName>MD</persName></editor><imprint><publisher>ELSEVIER</publisher><date type="published" when="1988"></date><biblScope unit="volume">62</biblScope><biblScope unit="issue">19</biblScope><biblScope unit="page" from="L74">L74</biblScope><biblScope unit="page" to="L77">L77</biblScope></imprint></monogr><idno type="istex">C1DDB68FBC4755B54AEA9704F971EF679C0DDD61</idno><idno type="DOI">10.1016/0002-9149(88)90021-5</idno><idno type="PII">0002-9149(88)90021-5</idno><idno type="ArticleID">88900215</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1988</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>During the last 2 decades, more than 1,000 patients have undergone surgical division of an accessory pathway; many refinements in epicardial mapping and surgical techniques have been made. In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to <5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. Whereas our current thought is that surgery should be limited to those adults who fail to respond to pharmacologie therapy, advances in atrial endocardial and epicardial mapping, as well as surgical techniques, may expand the role of surgery in the treatment of ectopic atrial tachycardia.</p></abstract></profileDesc><revisionDesc><change when="1988">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>88900215</aid><ce:pii>0002-9149(88)90021-5</ce:pii><ce:doi>10.1016/0002-9149(88)90021-5</ce:doi><ce:copyright type="unknown" year="1988"></ce:copyright></item-info><head><ce:title>Nonpharmacologic treatment of supraventricular tachycardia</ce:title><ce:author-group><ce:author><ce:given-name>Eric N.</ce:given-name><ce:surname>Prystowsky</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Douglas</ce:given-name><ce:surname>Packer</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:affiliation><ce:textfn>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Eric N. Prystowsky, MD, Northside Cardiology, PC, 8402 Harcourt Road, Indianapolis, Indiana 46260.</ce:text></ce:correspondence></ce:author-group><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">During the last 2 decades, more than 1,000 patients have undergone surgical division of an accessory pathway; many refinements in epicardial mapping and surgical techniques have been made. In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to <5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. Whereas our current thought is that surgery should be limited to those adults who fail to respond to pharmacologie therapy, advances in atrial endocardial and epicardial mapping, as well as surgical techniques, may expand the role of surgery in the treatment of ectopic atrial tachycardia.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Nonpharmacologic treatment of supraventricular tachycardia</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Nonpharmacologic treatment of supraventricular tachycardia</title></titleInfo><name type="personal"><namePart type="given">Eric N.</namePart><namePart type="family">Prystowsky</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</affiliation><description>Address for reprints: Eric N. Prystowsky, MD, Northside Cardiology, PC, 8402 Harcourt Road, Indianapolis, Indiana 46260.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Douglas</namePart><namePart type="family">Packer</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Departments of Medicine and Cardiology, Duke University Medical Center, Durham, North Carolina, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1988</dateIssued><copyrightDate encoding="w3cdtf">1988</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">During the last 2 decades, more than 1,000 patients have undergone surgical division of an accessory pathway; many refinements in epicardial mapping and surgical techniques have been made. In institutions where the procedure is routinely performed, the rate of successful accessory pathway interruption now approaches 98%. Concomitant risk of complete heart block among patients with posteroseptal pathways has declined to <5%. Among patients with other organic heart disease, myocardial preservation techniques result in mortality rates within 1 to 2%; among those with significant cardiac abnormalities, the mortality rate is 4 to 6%.Two techniques are generally used to ablate an accessory pathway: the endocardial and the epicardial. The aim of both approaches is to identify the site of the accessary pathway and disarticulate the atrioventricular groove or expose and ablate the atrioventricular junction to interrupt accessory pathway conduction. Although each technique has its advantages, the choice of technique is far less important than the skill of the surgeon and clinical electrophysiologist performing the procedure.Newer surgical techniques include application of external epicardial shocks in the area of the accessory pathway and use of a cryosurgical probe in the sinus to ablate accessory pathways. 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AMERICAN JOURNAL OF CARDIOLOGY DECEMBER</title><imprint><biblScope unit="volume">20</biblScope><biblScope unit="page">77</biblScope><date type="published" when="1988"></date></imprint></monogr></biblStruct></listBibl></back></text></istex:refBibTEI></enrichments></istex></record>Pour manipuler ce document sous Unix (Dilib)
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