| Journal: | Archivos de cardiología de México |
| Database: | PERIÓDICA |
| System number: | 000179888 |
| ISSN: | 1405-9940 |
| Authors: | Medeiros, Argelia1 Iturralde, Pedro Guevara Valdivia, Milton E Ramírez, Samuel Rodríguez, Laura Rodríguez, Ignacio Mendoza, Celso Colín, Luis |
| Institutions: | 1Instituto Nacional de Cardiología Ignacio Chávez, Departamento de Electrofisiología, México, Distrito Federal. México |
| Year: | 2001 |
| Season: | Jul-Sep |
| Volumen: | 71 |
| Number: | 3 |
| Pages: | 221-226 |
| Country: | México |
| Language: | Español |
| Document type: | Nota breve o noticia |
| Approach: | Analítico, caso clínico |
| Spanish abstract | El flutter auricular es una de las arritmias más frecuentes en pacientes operados de comunicación interauricular; su incidencia es cercana al 14%. Una vez desarrollada esta arritmia, la morbilidad es alta. Presentamos los resultados de la ablación transoperatoria del circuito del flutter auricular, tanto profiláctica como terapéutica, en 21 pacientes. Seis (28.5%), de éstos, tenían flutter auricular antes de la cirugía y 15 (71.4%) se encontraban en ritmo sinusal. Se realizó ablación transoperatoria con catéter, profiláctica o terspéutica en cuatro líneas: 1. De la valva posterior de la tricúspide a la vena cava inferior. 2. Del seno coronario a la vena cava inferior. 3. Del anillo tricuspídeo al ostium del seno coronario y 4. De la atriotomía al defecto interatrial. En el seguimiento postoperatorio a 6 meses, no se documentó ningún caso de novo en los que se realizó profilaxis; 2 (33.3%) pacientes, con flutter auricular antes de la cirugía, tuvieron recurrencia de la arritmia. Un paciente tuvo bloqueo auriculoventricular completo y se tuvo que implantar un marca-paso definitivo. La edad al momento quirúrgico, la presión sistólica pulmonar y las arritmias antes de la cirugía fueron significativamente mayores en los pacientes con flutter postoperatorio |
| English abstract | 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 |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Sistema cardiovascular, Ablación, Catéter, Comunicación interauricular, Fibrilación auricular |
| Keyword: | Medicine, Cardiovascular system, Surgery, Ablation, Catheter, Atrial septal defect, Atrial flutter |
| Full text: | Texto completo (Ver PDF) |
