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The Annals of Thoracic Surgery, Vol 47, 566-568, Copyright © 1989 by The Society of Thoracic Surgeons
AW Lee, FA Crawford Jr, PC Gillette and SM Roble
Eighteen patients with supraventricular tachycardia refractory to medical
therapy underwent preoperative electrophysiological study and subsequent
operation. There were 6 female and 12 male patients ranging in age from 1.5
to 31.6 years (mean age, 11.9 +/- 7.8 years). Eleven had classic
Wolff-Parkinson-White syndrome with intermittent tachycardia, and 7 had a
form of permanent junctional reciprocating tachycardia. Five had impaired
left ventricular function preoperatively. The location of the accessory
conduction pathway was anteroseptal in 3, posteroseptal in 12, and both
anteroseptal and posteroseptal in 3 patients. Pathway location was
confirmed by intraoperative mapping in all patients. The pathways were
ablated utilizing a cryoprobe at -70 degrees C. All patients survived the
operation, had immediate abolishment of delta waves and tachycardia, and
were considered cured at the time of hospital discharge. Sixteen (89%)
remain cured at a mean follow-up of 16.9 months. One patient with a
posteroseptal pathway no longer has a delta wave but has had poorly
documented episodes of tachycardia and is taking medication. One other
patient with both anteroseptal and posteroseptal pathways had a recurrent
delta wave 6 months postoperatively but has had no tachycardia and is
asymptomatic without medication. No patient experienced heart block.
Ventricular function has returned to normal in all 5 patients with impaired
function preoperatively. Cryoablation is an effective method of abolishing
accessory conduction pathways located in the anteroseptal or posteroseptal
region. The method is easy, and results are comparable with those of other
techniques previously described.
ARTICLES
Cryoablation of septal pathways in patients with supraventricular tachyarrhythmias
Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston 29425.
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A. W. Lee, F. A. Crawford jr, P. C. Gillette, and S. M. Roble Cryoablation of Septal Pathways in Patients with Supraventricular Tachyarrhythmias Ann. Thorac. Surg., April 1, 1997; 63(4): 1205 - 1205. [Full Text] |
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