DIAGNOSIS AND SURGICAL-TREATMENT OF ECTOPIC ATRIAL TACHYCARDIA

被引：10

作者：

BREDIKIS, J

LEKAS, R

BENETIS, R

SILEIKIS, V

VEIKUTIS, V

KRISCIUKAITIS, A

VASKELYTE, J

机构：

[1] Kaunas Arrhythmia Surgery Centre, Kaunas

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 04期

关键词：

ECTOPIC TACHYCARDIA; CLOSED HEART APPROACH; CRYOTECHNIQUE;

D O I：

10.1016/1010-7940(91)90030-N

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Eighty-two patients with ectopic atrial tachycardia (EAT) were subjected to radical closed heart surgery (without cardiopulmonary bypass). The age of the patients ranged from 1 to 51 years. Permanent EAT was present in 19 patients, incessant EAT in 14, and paroxysmal EAT in 49 patients. Preoperative electrophysiological study included computed analysis of the P wave vector. Ectopic foci were established in the right atrium in 34 patients, in the left atrium in 11, in the interatrial septum in 32, and extracardially in 5 patients. For ablation or isolation of the foci, the cryogenic technique was used in 74 patients, cryo- and laser techniques in 4, and the laser technique alone in 1 patient. In 3 patients resection of the atrial auricles including the ectopic focus was undertaken. In 4 patients complete AV block was induced and a cardiac pacemaker implanted. After primary surgery, favourable results were obtained in 71 patients. In 11 patients recurrences were observed; 8 of these patients underwent successful repeat surgery. In 3 patients medical treatment was effective. Finally, the follow-up results have been promising - 79 patients (96.4%) (including 4 patients in whom a complete AV block was created) have become arrhythmia-free. When EAT is resistant to medical treatment, closed heart ablation of the ectopic focus has proved to be safe (no mortality or morbidity) and effective. It can therefore be recommended not only for the termination of EAT but also for the prevention of dilated cardiomyopathy.

引用

页码：199 / 204

页数：6

共 21 条

[1]

Anderson K.P., Stinson E.B., Mason J.W., Surgical exclusion of focal paroxysmal atrial tachycardia, Am J Cardiol, 49, pp. 869-874, (1982)

[2]

Bredikis J.J., Cryosurgical ablation of atrioventricular junction without the use of extracorporeal circulation, J Thorac Cardiovasc Surg, 90, pp. 61-67, (1985)

[3]

Bredikis J.J., Bukauskas F.F., Zebrauskas R.I., Sakalauskas J.J., Loschilov V., Nevsky V., Bredikis A.K., Lekas R.I., Cryosurgical ablation of right parietal and septal accessory atrioventricular connections without the use of extracorporeal circulation, J Thorac Cardiovasc Surg, 90, pp. 206-211, (1985)

[4]

Bredikis J.J., Obelienius V., Knepa A., The first clinical experience in laser application in arrhythmia surgery, International Symposium on Cardiac Arrhythmias (Abstracts), Kanazawa, 52, (1986)

[5]

Bredikis J., Baksiene N., Kirkutis A., Putelis R., Sileikis V., Benetis R., Lekas R., Bukauskas F., Veikutis V., Kevalas R., Diagnostics and surgical treatment of children with ectopic atrial tachycardia, Mokslas Publishers, Vilnius, pp. 174-184, (1987)

[6]

Coumel P.H., Aigueperse J., Perrault M.A., Fantoni A., Slama R., Bouvraix Y., Reperage et tentative d’ecerese chirurgicale d’un foyer ectopique auriculaire gauche avec tachycardie rebelle, Ann Cardiol Angeol, 22, pp. 189-199, (1973)

[7]

Critelli G., Perticone F., Loltori F., Monda V., Gallagher J., Closed chest modificationof atrioventricular conduction system in man for treatment of refractory supraventricular tachycardia, Br Heart J, 49, pp. 544-549, (1983)

[8]

Frank G., Baumgart D., Klein H., Luhmer I., Kallfelz H.C., Borst H.G., Successful surgical treatment of focal atrial tachycardia - a case report and review of the literature, Thorac Cardiovasc Surg, 34, pp. 398-402, (1986)

[9]

Gillette P.C., Garson A., Hesslein P.S., Karpawich P.P., Tierney R., Cooley D.A., McNamara D.G., Successful surgical treatment of atrial, junctional and ventricular tachycardia unassociated with accessory connections in infants and children, Am Heart J, 102, pp. 984-991, (1981)

[10]

Giorgi L.V., Hartzler G.O., Hamaker W.A., Incessant focal atrial tachycardia: A surgical remediable cause of cardiomyopathy, J Thorac Cardiovasc Surg, 87, pp. 466-469, (1984)

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