Surgical alternatives for supraventricular tachycardias
Identifieur interne : 000906 ( Main/Corpus ); précédent : 000905; suivant : 000907Surgical alternatives for supraventricular tachycardias
Auteurs : Gerard M. Guiraudon ; George J. Klein ; Arjun D. Sharma ; Raymond YeeSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1989.
Abstract
Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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 atrioventricrdar (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 cryoabladon 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.
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DOI: 10.1016/0002-9149(89)91209-5
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Sharma</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A7931236F13885782EFFD2FD29B859BFAF2A811D</idno><date when="1989" year="1989">1989</date><idno type="doi">10.1016/0002-9149(89)91209-5</idno><idno type="url">https://api.istex.fr/document/A7931236F13885782EFFD2FD29B859BFAF2A811D/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000906</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Surgical alternatives for supraventricular tachycardias</title><author><name sortKey="Guiraudon, Gerard M" sort="Guiraudon, Gerard M" uniqKey="Guiraudon G" first="Gerard M." last="Guiraudon">Gerard M. Guiraudon</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Sharma, Arjun D" sort="Sharma, Arjun D" uniqKey="Sharma A" first="Arjun D." last="Sharma">Arjun D. Sharma</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</mods:affiliation></affiliation></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><affiliation><mods:affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</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="J92">J92</biblScope><biblScope unit="page" to="J96">J96</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">A7931236F13885782EFFD2FD29B859BFAF2A811D</idno><idno type="DOI">10.1016/0002-9149(89)91209-5</idno><idno type="PII">0002-9149(89)91209-5</idno><idno type="ArticleID">89912095</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">Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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 atrioventricrdar (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 cryoabladon 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><istex><corpusName>elsevier</corpusName><author><json:item><name>Gerard M. Guiraudon MD</name><affiliations><json:string>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item><json:item><name>George J. Klein MD</name><affiliations><json:string>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item><json:item><name>Arjun D. Sharma MD</name><affiliations><json:string>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</json:string></affiliations></json:item><json:item><name>Raymond Yee MD</name><affiliations><json:string>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</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>89912095</json:string></articleId><language><json:string>eng</json:string></language><abstract>Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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 atrioventricrdar (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 cryoabladon 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.</abstract><qualityIndicators><score>5.815</score><pdfVersion>1.3</pdfVersion><pdfPageSize>576.28 x 864 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1581</abstractCharCount><pdfWordCount>3307</pdfWordCount><pdfCharCount>22897</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>209</abstractWordCount></qualityIndicators><title>Surgical alternatives for supraventricular tachycardias</title><pii><json:string>0002-9149(89)91209-5</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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Guiraudon, MD, University Hospital, 339 Windermere Road, London, Ontario, Canada.</note><affiliation>Address for reprints: Gerard M. Guiraudon, MD, University Hospital, 339 Windermere Road, London, Ontario, Canada.</affiliation><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation></author><author><persName><forename type="first">George J.</forename><surname>Klein</surname></persName><roleName type="degree">MD</roleName><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation></author><author><persName><forename type="first">Arjun D.</forename><surname>Sharma</surname></persName><roleName type="degree">MD</roleName><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation></author><author><persName><forename type="first">Raymond</forename><surname>Yee</surname></persName><roleName type="degree">MD</roleName><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</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)X0969-1</idno><meeting><addName>A Symposium: New Trends in the Treatment of Rhythm Disorders, Acapulco, Mexico</addName><date>19890206</date><date>19890207</date></meeting><editor><persName>A. 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="J92">J92</biblScope><biblScope unit="page" to="J96">J96</biblScope></imprint></monogr><idno type="istex">A7931236F13885782EFFD2FD29B859BFAF2A811D</idno><idno type="DOI">10.1016/0002-9149(89)91209-5</idno><idno type="PII">0002-9149(89)91209-5</idno><idno type="ArticleID">89912095</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1989</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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 atrioventricrdar (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 cryoabladon 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.</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>89912095</aid><ce:pii>0002-9149(89)91209-5</ce:pii><ce:doi>10.1016/0002-9149(89)91209-5</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:article-footnote><ce:label>☆</ce:label><ce:note-para>This study was supported by the Heart and Stroke Foundation of Ontario, London, Ontario, Canada.</ce:note-para></ce:article-footnote><ce:title>Surgical alternatives for supraventricular tachycardias</ce:title><ce:author-group><ce:author><ce:given-name>Gerard M.</ce:given-name><ce:surname>Guiraudon</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>George J.</ce:given-name><ce:surname>Klein</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Arjun D.</ce:given-name><ce:surname>Sharma</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:author><ce:given-name>Raymond</ce:given-name><ce:surname>Yee</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:affiliation><ce:textfn>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Gerard M. Guiraudon, MD, University Hospital, 339 Windermere Road, London, Ontario, Canada.</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">Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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.”</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">The Wolff-Parkinson-White syndrome is characterized by an accessory atrioventricrdar (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.</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">AV nodal reentrant tachycardia can be cured using direct AV nodal dissection (or perinodal cryoablation). Atrial flutter can be interrupted by cryoabladon 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.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Surgical alternatives for supraventricular tachycardias</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Surgical alternatives for supraventricular tachycardias</title></titleInfo><name type="personal"><namePart type="given">Gerard M.</namePart><namePart type="family">Guiraudon</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation><description>Address for reprints: Gerard M. Guiraudon, MD, University Hospital, 339 Windermere Road, London, Ontario, Canada.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">George J.</namePart><namePart type="family">Klein</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arjun D.</namePart><namePart type="family">Sharma</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Raymond</namePart><namePart type="family">Yee</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Departments of Surgery and Medicine, University of Western Ontario, University Hospital, London, Ontario, Canada</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">Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electro-physiologic 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 atrioventricrdar (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 cryoabladon 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). 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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 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