Surgical treatment of the Wolff-Parkinson-White syndrome by epicardial electrical ablation

• Published in: The Annals of thoracic surgery Vol. 51; no. 4; pp. 563 - 572
• Main Authors: Bockeria, Leo A., Kupatadze, Nino I., Saprigin, Dmitry B., Aslanidi, Irakly P., Chigogidze, Nickolay A., Dyadyurko, Andrey M., Poplavskaya, Ludmila M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-04-1991; Elsevier Science
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Child; Coronary Angiography; Creatine Kinase - metabolism; Electrocardiography; Electrocardiography, Ambulatory; Electrocoagulation - adverse effects; Electrocoagulation - methods; Evaluation Studies as Topic; Exercise Test; Female; Follow-Up Studies; Heart; Heart Conduction System - physiology; Heart Conduction System - surgery; Hemodynamics - physiology; Humans; Male; Medical sciences; Middle Aged; Myocardial Contraction - physiology; Myocardium - pathology; Necrosis; Nitroglycerin; Radionuclide Ventriculography; Retrospective Studies; Wolff-Parkinson-White Syndrome - physiopathology; Wolff-Parkinson-White Syndrome - surgery; Heart; Human; Arrhythmia; Electric; Epicardium; Cardiovascular disease; Wolff Parkinson White syndrome; Ablation; Conduction disorder; Excitability disorder; Treatment; Surgery; Accessory bundle; Technique
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(91)90312-E

A new operation to eliminate accessory pathways—epicardial electrical ablation—is described. In a group of 201 patients without concomitant disease, the mortality rate was 0.5% and the overall efficacy of the operation for free wall accessory pathways, 98%. A retrospective clinical study of 44 unselected patients was performed to examine how safe epicardial electrical ablation is. The criteria for intraoperative effectiveness were disappearance of both the delta wave and retrograde conduction and inability to induce tachycardia. In the postoperative and follow-up periods, the following were reviewed: electrocardiograms; Holter monitor recordings (24 to 26 hours); release of the myocardial-specific isoenzyime of creatine kinase; intracardiac hemodynamics and myocardial contractility (radionuclide methods); selective coronary arteriograms and ventriculograms; mean work capacity (bicycle ergometer); diagnostic transesophageal electrical stimulation; and histology of the area of ablation. The main conclusion of this study is that epicardial electrical ablation is a highly efficient and safe operation for surgical elimination of parietal accessory pathways in patients with Wolff-Parkinson-White syndrome. Its advantages are its technical simplicity and the opportunity to review results immediately during the operation.