Anti-arrhythmic surgery for atrioventricular junctional and atrioventricular re-entrant tachycardia--a report of six cases.
Since 15th March 1989, six patients with recurrent supraventricular tachycardia (SVT) had antiarrhythmic surgery performed. There were 4 males and 2 females, ages ranged from 23 to 62 years (mean 41 years). Two of these patients with the Wolff Parkinson White (WPW) syndrome also had syncope. Five of these patients had atrioventricular re-entrant tachycardia (AVRT) involving the bypass tracts. Two patients with the WPW syndrome had persistent antegrade conduction, two had intermittent conduction and the last patient had no antegrade conduction via the bypass tract. The bypass tracts were localised at the left free wall in all the five patients. Only one patient had atrioventricular junctional re-entrant tachycardia (AVJRT) of the slow-fast type. The indications for surgery for these patients include failed medical therapy, "dangerous" arrhythmias and patient's preference. All the patients had surgery performed using the endocardial dissection technique on the cardioplegic heart. There were no perioperative mortality and morbidity. All the patients were discharged within 2 weeks. To date, none of the patients had clinical recurrence of SVT and only one patient remained in atrial fibrillation and is on digoxin. In conclusion, antiarrhythmic surgery should be considered for patients with "symptomatic" palpitations as it is curative with a resumption to normal life.
Koo
C C
CC
Department of Cardiology, Singapore General Hospital.
Tong
M C
MC
Tan
A T
AT
Heng
G T
GT
Teo
W S
WS
Chua
T S
TS
Ong
K K
KK
Ng
S S
SS
Myint
T
T
D000328:Adult; D002036:Bundle of His / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology / Q000601:surgery*; D013613:Tachycardia, Ectopic Junctional / Q000503:physiopathology / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000601:surgery*; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*