‘Sinus node’ dysfunction associated with left atrial isomerism

Aim To compare the incidence of a permanent pacemaker (PP) implantation based on the chosen treatment technology (biatrial ablation, BA, or left atrial ablation (LAA) for long-standing persistent atrial fibrillation (AF) with simultaneous coronary bypass (CB).Material and methods The study included 116 patients with long-standing persistent AF and indications for CB. Patients were randomized to two equal groups (58 patients in each). Group 1 underwent BA in combination with CB; group 2 patients underwent isolated LAA with simultaneous CB under the conditions of artificial circulation. Incidence of PP implantation was assessed during the early (to 30 days) and late (to 60 months) postoperative periods.Results For the observation period, a total of 9 PPs was implanted in both groups, 6 in the BA group and 3 in the LAA group (odds ratio, OR, 0.5; 95 % confidence interval, CI, 0.1–2.4; р=0.490). During the early postoperative period, 5 patients in the BA group and 2 patients in the LAA group were implanted with PP (OR, 0.4; 95 % CI. 0–2.5; р=0.438). During the late postoperative period, one (2%) patient of the BA group was implanted with a permanent PP at 30 months of follow-up due to the development of sick sinus syndrome (SSS); also, one (2%) patient of the LAA group required PP implantation at 54 months of follow-up due to the development of SSS. The causes for PP implantation in the BA group included the development of complete atrioventricular (AV) block in 9 % of cases (95 % CI, 4–19 %); sinus node dysfunction and junctional rhythm in 2 % of cases (95 % CI, 0–9 %). Compared to this group, the LAA group showed a statistically significant difference in the incidence of AV block (0 cases, р=0.047). The major cause for PP implantation in the LAA group was the development of sinus node dysfunction in 3 (5 %) patients (95 % CI, 2–14 %).Conclusion The use of BA in surgical treatment of long-standing persistent AF with simultaneous myocardial revascularization is associated with a high risk of AV block, which requires permanent PP implantation in the postoperative period. Total incidence of permanent PP implantation for dysfunction of the cardiac conduction system following the combination surgical treatment of long-standing persistent AF and IHD, either CB and LAA or BA, did not differ between the treatment groups both in early and late postoperative periods.

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Rescue Percutaneous Coronary Intervention for Sinus Node Dysfunction Following Left Atrial Flutter Ablation

HeartRhythm Case Reports ◽

10.1016/j.hrcr.2021.04.015 ◽

2021 ◽

Author(s):

Yuichiro Miyazaki ◽

Nobuhiko Ueda ◽

Fumiyuki Otsuka ◽

Koji Miyamoto ◽

Teruo Noguchi ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Atrial Flutter ◽

Left Atrial ◽

Sinus Node ◽

Coronary Intervention ◽

Sinus Node Dysfunction ◽

Percutaneous Coronary ◽

Atrial Flutter Ablation

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Recurrent atrial myxoma, right atriotomy, and sinus node dysfunction: A case of interdisciplinary care

The Southwest Respiratory and Critical Care Chronicles ◽

10.12746/swrccc.v6i25.484 ◽

2018 ◽

Vol 6 (25) ◽

pp. 42-46

Author(s):

Erwin Argueta ◽

Kelly Ratheal ◽

Sofia Prieto ◽

Ralph Paone ◽

Leigh Ann Jenkins ◽

...

Keyword(s):

Left Atrial ◽

Surgical Intervention ◽

Sinus Node ◽

Atrial Myxoma ◽

Sinus Node Dysfunction ◽

Definitive Treatment ◽

Cardiac Tumors ◽

Interdisciplinary Care ◽

Left Atrial Myxoma ◽

Primary Cardiac Tumors

Primary cardiac tumors are rare, and atrial myxomas represent about half of the benigntumors encountered. When found, definitive treatment is surgical resection. Followingresection of these tumors, recurrence is possible, and these patients need regular follow-up.In the case of recurrence, repeat surgical intervention is feasible, but the potential for moredisruption in atrial anatomy has to be considered. This could contribute to cardiac arrhythmias,and anticipation of these events is necessary to optimize patient care. We present the caseof a woman with a recurrent left atrial myxoma who developed sinus node dysfunction afterresection and discuss her clinical management.

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DOES «MAZE» PROCEDURE AFFECT ON HOSPITAL RESULTS OF MITRAL VALVE REPLACEMENT?

Jounal of arrhythmology ◽

10.35336/va-2019-2-37-44 ◽

2019 ◽

Vol 26 (2(96)) ◽

pp. 37-44

Author(s):

A. Sh. Revishvili ◽

V. A. Popov ◽

V. V. Aminov ◽

M. A. Svetkin

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Mitral Valve Disease ◽

Left Atrial ◽

Sinus Node ◽

Sinus Node Dysfunction ◽

Atrial Size

Aims.To assess the outcomes of atrial fibrillation (AF) treatment by radiofrequency ablation for patients with mitral valve replacement, the analysis of short-term results of 128 patients was performed.Methods.Mean age of the patients was 56,7±9,6 (29 - 79) years, males - 39, females - 89. Most of the patients had longstanding persistent AF - 81 (63,3%), 28 (21,9%) had persistent AF and 19 (14,8%) - paroxysmal AF. The indications for surgery were: rheumatic mitral valve disease in 105 patients (82%), degerative mitral valve disease - in 21 (16,4%) and with treated infectious endocarditis - in 2 (1,6%). Maze IV procedure was carried out in all cases.Results.Hospital mortality was 0,8% (1 patient). Ten patients (7,9%) required pacemaker implantation. The indications were sinus node dysfunction in 7 patients, bradycardia AF - in 2 patients, AV node dysfunction - in 1. At the discharge 88 patients (69,3%) had a sinus rhythm, 10 (7,9%) - atrial rhythm, pacemaker rhythm with sinus node dysfunction patients - in 4 (3,1%) and AF - in 25 (19,7%). Thus, the rate of freedom from atrial fibrillation was 80,3% (102 patients). The effectiveness of ablation for paroxysmal AF was 100%, persistent - 74,1%, longstanding persistent - 77,8% (p=0,006). To reveal other predictors of freedom from AF at the discharge each ECHO parameter was included in the simple logistic regression analysis. Statistically significant p-value was obtained for the preoperative right atrial size (p=0,005), and close to it for the left atrial size, especially for the index left atrial volume/body surface area (p=0,052).Conclusion.Thus, the radiofrequency ablation is an effective method for treatment of AF in patients undergoing mitral valve replacement. The rate of freedom from AF at the discharge is 80,3%. The predictors of freedom from AF at the discharge are preoperative form of AF and preoperative size of atria.

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