HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Velimirovic, D. Articles by Pavlovic, S. U. Search for Related Content PubMed PubMed Citation Articles by Velimirovic, D. Articles by Pavlovic, S. U.

European Journal of Cardio-Thoracic Surgery, Vol 7, 580-586, Copyright © 1993 by European Association for Cardio-thoracic Surgery

ARTICLES

Control of ventricular rate by interatrial septal incision and crista terminalis myotomy in the patients with atrial fibrillation undergoing mitral valve replacement

D Velimirovic, P Petrovic, P Djukic, M Ristic and SU Pavlovic
Institute of Cardiovascular Diseases, University Clinical Center, Belgrade, Yugoslavia.

The aim of the study was to analyze the effect of surgical moderation of conduction from the atrium to the atrio-ventricular (AV) node on ventricular response in 30 patients with atrial fibrillation (AF) undergoing mitral valve replacement (MVR). Besides the usual diagnostics, echocardiographic evaluation of the size of the left atrium was performed in all patients, as a parameter of stability of rhythm conversion by drugs. Surgical treatment was applied exclusively in cases where, judging by these parameters, there was little chance for drug treatment to be effective. All patients (mean age 50 years) had severe mitral valve disease (NYHA III and IV), chronic AF and irregular ventricular rate, and underwent mitral valve replacement with mechanical valve. The patients were divided into three groups of ten patients each. In group I: MVR was combined with interatrial septal incision (IASI) to study the effect of the moderation of conduction from the interatrial septum to the AV node; in group II: after MVR, IASI was combined with crista terminalis myotomy (CTM) to study the additional effect of the moderation of conduction along the crista terminalis to the AV node; in group III (control): MVR was performed through left atriotomy, without antiarrhythmic incisions. Ventricular response was studied in two phases: In the immediate postoperative period (up to 7 days), using continuous electrocardiographic (ECG) monitoring, and 2 months postoperatively, using 24 h Holter monitoring with the results compared to a preoperative 24 h recording. Postoperative AF occurred in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)