LEFT ATRIAL ISOLATION - NEW TECHNIQUE FOR THE TREATMENT OF SUPRAVENTRICULAR ARRHYTHMIAS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 80  (3) , 373-380
Abstract
Surgical management of refractory ectopic supraventricular tachycardia arising in the left atrium requires cryoablation of the bundle of His and insertion of a permanent ventricular pacemaker. A technique was developed to isolate the left atrium electrically from the remainder of the heart so that an artificial pacemaking system would be unnecessary. Ten adult dogs were subjected to cardiopulmonary bypass and a standard left atriotomy was extended anteriorly across the mitral valve anulus between the right and left fibrous trigones. Posteriorly the atriotomy was extended across the mitral valve anulus just to the left of the posterior crux and interatrial septum. The muscular interatrial fibers accompanying the coronary sinus were cryoablated at -60.degree. C for 2 min. Postoperatively all animals remained in normal sinus rhythm. Rapid left atrial pacing did not affect the rate or rhythm of the remainder of the heart. Preliminary hemodynamic measurements suggest that loss of the synchronous left atrial kick does not significantly affect left ventricular preload, afterload or cardiac output. This technique offers an alternative to the current surgical approach for management of refractory ectopic supraventricular tachycardia arising in the left atrium.