The Annals of Thoracic Surgery, Vol 49, 466-468, Copyright © 1990 by The Society of Thoracic Surgeons
Surgical cure of automatic atrial tachycardia by partial left atrial isolation
JP Chang, CH Chang, SJ Yeh, T Yamamoto and D Wu
Section of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Partial left atrial isolation was performed in a 16-year-old girl with
persistent atrial tachycardia refractory to antiarrhythmic agents for 3
years. Intraoperative atrial epicardial and endocardial mapping showed that
the earliest atrial activation occurred in an area lateral to the junction
of the right superior pulmonary vein and the left atrium. An incision
isolating the right half of the left atrial body containing the area of the
earliest atrial activation and both right pulmonary veins from the
remainder of the left atrium was made. The incision was then
reapproximated. An excision encircling the interatrial septum containing
the upper anterior portion of the septum with early activation was also
made, and the atrial septal defect was repaired with a pericardial patch.
The patient has been in sinus rhythm and free of arrhythmia for a follow-up
period of 12 months.