Prevention of postsurgical atrial tachycardia with a modified right atrial free wall incision》.pdf

Prevention of postsurgical atrial tachycardia with a modified right atrial free wall incision Gang Yang, MD,* Xianfeng Du, MD,* Buqing Ni, MD,† Hongwu Chen, MD,* Rundi Qi, MD,* * * * * * Cheng Cai, MD, Yin Fang, MD, Bing Yang, MD, Weizhu Ju, MD, Fengxiang Zhang, MD, Mingfang Li, PhD,* Kai Gu, MD,* Yongfeng Shao, MD,† Minglong Chen, MD* * From the Division of Cardiology, First Affi liated Hospital of Nanjing Medical University, Nanjing, People ’s Republic of China and †Division of Cardio-Thoracic Surgery, First Affi liated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China. BACKGROUND Most postsurgical macroreentry atrial tachycardias ms for 5 and 10 mm (both group B), 15 mm (group A), and sham (PS-MATs) are atriotomy related; however, underlying mechanisms incision (P ¼ .017), respectively. Conduction properties correlated and prevention remain undefined. with histologic findings: the wider the corridor, the healthier its tissue. In group C (modified atriotomy), both corridors were OBJECTIVE The purpose of the present study was to investigate replaced by dense scar with complete conduction block. the electrophysiological and histologic bases of right atriotomy incision arrhythmogenicity and whether a modified atriotomy that CONCLUSION Atriotomy corridor width determines conduction extends the incisional line to the tricuspid annulus (TA) and inferior properties and contributes to arrhythmogenicity. A modified right vena cava (IVC) prevents PS-