Document Detail


Prevention of atrial flutter with cryoablation may be proarrhythmogenic.
MedLine Citation:
PMID:  17462387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial flutter is a serious problem after surgery for congenital heart disease. METHODS: We performed an intraoperative linear one-minute cryolesion between a right atriotomy and the tricuspid annulus to prevent atrial flutter in 17 consecutive adult patients undergoing surgery for congenital heart disease. Coronary angiography and electrophysiology study using an electroanatomic mapping system to assess the conduction across the line and to try to induce atrial flutter were performed three months after the operation in 15 patients. RESULTS: Eleven patients had bidirectional block in the cryolesion, four patients did not, and two patients refused the electrophysiology study and coronary angiography. All patients with terminal temperature below -151 degrees C had bidirectional block, while only one patient with terminal temperature above -151 degrees C had bidirectional block. No patient with bidirectional block and all patients without bidirectional block had inducible or spontaneous atrial flutter (p = 0.0007). No lesion of the right coronary artery was detected at coronary angiography. CONCLUSIONS: The success rate was suboptimal and the intervention is potentially proarrhythmogenic in patients without block. Preventive strategies targeting atrial flutter should be validated with regard to the block rate achieved.
Authors:
Peter Lukac; Vibeke E Hjortdal; Anders K Pedersen; Peter T Mortensen; Henrik K Jensen; Peter S Hansen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-27     Completed Date:  2007-05-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1717-23     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Skejby University Hospital, Aarhus, Denmark. lukacpe2@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Flutter / complications,  etiology,  prevention & control*
Cardiac Surgical Procedures / adverse effects*
Cryosurgery / adverse effects*
Feasibility Studies
Female
Heart Block / complications
Heart Defects, Congenital / surgery
Humans
Male
Middle Aged
Prospective Studies
Comments/Corrections
Comment In:
Ann Thorac Surg. 2007 May;83(5):1723   [PMID:  17462388 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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