Abstract

MADEIROS, Argelia et al. Prophylactic and therapeutic radiofrequency ablation of atrial flutter during surgical closure of atrial septal defect. A pilot study. Arch. Cardiol. Méx. [online]. 2001, vol.71, n.3, pp.221-226. ISSN 1665-1731.

Atrial flutter is one of the most common arrhythmias in patients with atrial septal defect, after surgery 14% of patients can develop it and may be associated with high morbidity. In this study we performed prophylactic and therspeutic abation of atrial flutter during atrial septal closure surgery drawing 4 lines; line 1, isthmus cavo-tricuspid, the area between the inferior vena cava and the tricuspid ring; line 2, the area between coronary sinus ostium and inferior vena cava; line 3, the area between tricuspid valve annulus and coronary sinus ostium; and line 4, the area between lateral atriotomy and atrial septal defect. Twenty-one patients were included, 6 (28.5%) patients had atrial flutter before surgery and 15 (71.4%) were in sinus rhythm. There were no new cases of strisl flutter, but at six months follow up 2 (33.3%) patients recidivated with atrial flutter. One patient developed high degree atrio-ventriculsr block and a pacemaker had to be implanted. Older age at the time of surgery and high systolic pulmonary pressure were significantly higher in those patients with atrial flutter before surgery and in patients with arrhythmias recurrence. Ablation of atrial flutter during atrial septsl closure surgery can be a good option for the treatment and prevention of atrial arrhythmias, but more studies are still needed.

Keywords : Atrial septal defect; Atrial flutter; Surgical radiofrequency catheter ablation.

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