Surgical management of tachyarrhythmias
Identifieur interne : 000830 ( Main/Corpus ); précédent : 000829; suivant : 000831Surgical management of tachyarrhythmias
Auteurs : Takashi Iwa ; Takuro Misaki ; Makoto Tsubota ; Kazuki IshidaSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1989.
Abstract
In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways.Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.
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DOI: 10.1016/0002-9149(89)91208-3
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Surgical management of tachyarrhythmias</title><author><name sortKey="Iwa, Takashi" sort="Iwa, Takashi" uniqKey="Iwa T" first="Takashi" last="Iwa">Takashi Iwa</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Misaki, Takuro" sort="Misaki, Takuro" uniqKey="Misaki T" first="Takuro" last="Misaki">Takuro Misaki</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Tsubota, Makoto" sort="Tsubota, Makoto" uniqKey="Tsubota M" first="Makoto" last="Tsubota">Makoto Tsubota</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Ishida, Kazuki" sort="Ishida, Kazuki" uniqKey="Ishida K" first="Kazuki" last="Ishida">Kazuki Ishida</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8CB2906370E15A531B671E9F8DCD85DA7BF2FA11</idno><date when="1989" year="1989">1989</date><idno type="doi">10.1016/0002-9149(89)91208-3</idno><idno type="url">https://api.istex.fr/document/8CB2906370E15A531B671E9F8DCD85DA7BF2FA11/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000830</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Surgical management of tachyarrhythmias</title><author><name sortKey="Iwa, Takashi" sort="Iwa, Takashi" uniqKey="Iwa T" first="Takashi" last="Iwa">Takashi Iwa</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Misaki, Takuro" sort="Misaki, Takuro" uniqKey="Misaki T" first="Takuro" last="Misaki">Takuro Misaki</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Tsubota, Makoto" sort="Tsubota, Makoto" uniqKey="Tsubota M" first="Makoto" last="Tsubota">Makoto Tsubota</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author><author><name sortKey="Ishida, Kazuki" sort="Ishida, Kazuki" uniqKey="Ishida K" first="Kazuki" last="Ishida">Kazuki Ishida</name><affiliation><mods:affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1989">1989</date><biblScope unit="volume">64</biblScope><biblScope unit="issue">20</biblScope><biblScope unit="page" from="J87">J87</biblScope><biblScope unit="page" to="J91">J91</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">8CB2906370E15A531B671E9F8DCD85DA7BF2FA11</idno><idno type="DOI">10.1016/0002-9149(89)91208-3</idno><idno type="PII">0002-9149(89)91208-3</idno><idno type="ArticleID">89912083</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways.Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Takashi Iwa MD</name><affiliations><json:string>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</json:string></affiliations></json:item><json:item><name>Takuro Misaki MD</name><affiliations><json:string>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</json:string></affiliations></json:item><json:item><name>Makoto Tsubota MD</name><affiliations><json:string>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</json:string></affiliations></json:item><json:item><name>Kazuki Ishida MD</name><affiliations><json:string>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Part III—Nondrug treatment of arrhythmias</value></json:item></subject><articleId><json:string>89912083</json:string></articleId><language><json:string>eng</json:string></language><abstract>In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways.Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.</abstract><qualityIndicators><score>5.496</score><pdfVersion>1.3</pdfVersion><pdfPageSize>575.84 x 864.28 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1623</abstractCharCount><pdfWordCount>2724</pdfWordCount><pdfCharCount>19162</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>231</abstractWordCount></qualityIndicators><title>Surgical management of tachyarrhythmias</title><pii><json:string>0002-9149(89)91208-3</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>64</volume><pii><json:string>S0002-9149(00)X0969-1</json:string></pii><editor><json:item><name>A. 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John Camm</persName></editor><editor><persName>MD</persName></editor><editor><persName>Yoshio Watanabe</persName></editor><editor><persName>MD</persName></editor><editor><persName>Kazuo Yamada</persName></editor><editor><persName>MD</persName></editor><imprint><publisher>ELSEVIER</publisher><date type="published" when="1989"></date><biblScope unit="volume">64</biblScope><biblScope unit="issue">20</biblScope><biblScope unit="page" from="J87">J87</biblScope><biblScope unit="page" to="J91">J91</biblScope></imprint></monogr><idno type="istex">8CB2906370E15A531B671E9F8DCD85DA7BF2FA11</idno><idno type="DOI">10.1016/0002-9149(89)91208-3</idno><idno type="PII">0002-9149(89)91208-3</idno><idno type="ArticleID">89912083</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1989</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways.Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.</p></abstract><textClass><keywords scheme="keyword"><list><head>Article category</head><item><term>Part III—Nondrug treatment of arrhythmias</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1989">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>89912083</aid><ce:pii>0002-9149(89)91208-3</ce:pii><ce:doi>10.1016/0002-9149(89)91208-3</ce:doi><ce:copyright type="unknown" year="1989"></ce:copyright><ce:doctopics><ce:doctopic><ce:text>Part III—Nondrug treatment of arrhythmias</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:title>Surgical management of tachyarrhythmias</ce:title><ce:author-group><ce:author><ce:given-name>Takashi</ce:given-name><ce:surname>Iwa</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>Takuro</ce:given-name><ce:surname>Misaki</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Makoto</ce:given-name><ce:surname>Tsubota</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Kazuki</ce:given-name><ce:surname>Ishida</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:affiliation><ce:textfn>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Takashi Iwa, MD, Department of Surgery (I), Kanazawa University School of Medicine, Takaramachi 13-l, Kanazawa 920, Japan.</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">In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Surgical management of tachyarrhythmias</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Surgical management of tachyarrhythmias</title></titleInfo><name type="personal"><namePart type="given">Takashi</namePart><namePart type="family">Iwa</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</affiliation><description>Address for reprints: Takashi Iwa, MD, Department of Surgery (I), Kanazawa University School of Medicine, Takaramachi 13-l, Kanazawa 920, Japan.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Takuro</namePart><namePart type="family">Misaki</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Makoto</namePart><namePart type="family">Tsubota</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kazuki</namePart><namePart type="family">Ishida</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Surgery (I), Kanazawa University School of Medicine, Kanazawa 920, Japan</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">1989</dateIssued><copyrightDate encoding="w3cdtf">1989</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">In this study of surgical procedures for various tachyarrfiythmias, Wolff-Parkinson-White syndrome comprised most of the cases. 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For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 × 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity.Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycaroia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.</abstract><subject><genre>Article category</genre><topic>Part III—Nondrug treatment of arrhythmias</topic></subject><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><name type="conference"><namePart>A Symposium: New Trends in the Treatment of Rhythm Disorders, Acapulco, Mexico</namePart><namePart type="date">19890206</namePart><namePart type="date" encoding="w3cdtf">19890207</namePart></name><name type="personal"><namePart>A. John Camm</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>MD</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>Yoshio Watanabe</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>MD</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>Kazuo Yamada</namePart><role><roleTerm type="text">editor</roleTerm></role></name><name type="personal"><namePart>MD</namePart><role><roleTerm type="text">editor</roleTerm></role></name><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19891205</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0969-1</identifier><part><date>19891205</date><detail type="issue"><title>A Symposium: New Trends in the Treatment of Rhythm Disorders, Acapulco, Mexico</title></detail><detail type="volume"><number>64</number><caption>vol.</caption></detail><detail type="issue"><number>20</number><caption>no.</caption></detail><extent unit="issue pages"><start>J1</start><end>J97</end></extent><extent unit="pages"><start>J87</start><end>J91</end></extent></part></relatedItem><identifier type="istex">8CB2906370E15A531B671E9F8DCD85DA7BF2FA11</identifier><identifier type="DOI">10.1016/0002-9149(89)91208-3</identifier><identifier type="PII">0002-9149(89)91208-3</identifier><identifier type="ArticleID">89912083</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/8CB2906370E15A531B671E9F8DCD85DA7BF2FA11/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><monogr><title level="m" type="main">Surgical treatment of Wolff-Parkinson-White syndrome. 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