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Selective surgical ablation of the slow atrioventricular nodal pathway by posterior perinodal dissection

1993; Elsevier BV; Volume: 71; Issue: 16 Linguagem: Inglês

10.1016/0002-9149(93)90613-h

1879-1913

Huey‐Ming Lo, Fang‐Yue Lin, Chuen-Den Tseng, Yuh-Shiun Jong, Tser-Haw Chern, Yüng-Zu Tseng,

Atomic and Subatomic Physics Research

Although it has been demonstrated that dual atrioventricular (AV) nodal physiology usually forms the basis of AV nodal reentry,1 the anatomic location of the dual nodal pathways remains disputed. The delineation of the surgical anatomy of the reentry circuit is of considerable importance from the viewpoint of surgery and catheter ablation. In a previous report, we proposed that the natural dual atrionodal inputs may in some cases function as dual AV nodal physiology and thereby facilitate the formation of AV nodal reentry.2 Therefore, if 1 atrionodal input is interrupted, the dual AV nodal physiology may disappear, and the nodal reentry should be cured. Because the posterior perinodal dissection was much safer than the anterior dissection, we performed posterior dissection for patients presenting with dual AV nodal pathways. Postoperative follow-up studies showed that the slow pathway disappeared, and no AV nodal reentrant tachycardia could be induced.