HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Vibeke E. Hjortdal Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lukac, P. Articles by Hansen, P. S. Search for Related Content PubMed PubMed Citation Articles by Lukac, P. Articles by Hansen, P. S. Related Collections Electrophysiology - arrhythmias

Ann Thorac Surg 2006;81:509-513
© 2006 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Atrial Incision Affects the Incidence of Atrial Tachycardia After Mitral Valve Surgery

^a Department of Cardiology, Skejby University Hospital, Aarhus, Denmark
^b Department of Thoracic Surgery, Skejby University Hospital, Aarhus, Denmark

Accepted for publication July 26, 2005.

^_* Address correspondence to Dr Lukac, Department of Cardiology, Skejby University Hospital, DK-8200 Aarhus N, Denmark (Email: lukacpe2{at}hotmail.com).

BACKGROUND: Atrial fibrillation is common after mitral valve surgery. We do not know the incidence of atrial tachycardia and how it depends on the surgical approach used.

METHODS: The subjects of the study were 213 consecutive patients who had surgery for mitral valve disease from January 1, 2001, through January 26, 2004. The surgeons used either the superior transseptal approach (69 patients, group A) or left atrial approach (144 patients, group B). An investigator, blinded for the approach used, analyzed all 12-lead electrocardiograms taken during the admission after the operation. The data were analyzed using the Cox regression analysis as time from the operation until documentation of atrial tachycardia or atrial fibrillation on a 12-lead electrocardiogram. Hazard ratio (95% confidence interval) is reported.

RESULTS: The superior transseptal approach (2.0 [1.1 to 3.5], p = 0.023), age 60 years or more (2.3 [1.2 to 4.6], p = 0.015), and male sex (2.6 [1.3 to 5.2], p = 0.007) were independent predictors of atrial tachycardia. Age 60 years or more was the only independent predictor of atrial fibrillation (2.0 [1.2 to 3.3], p = 0.007). Although atrial tachycardia was less frequent than atrial fibrillation in group B (p < 0.001), atrial tachycardia was as common as atrial fibrillation in group A (p = 0.149).

CONCLUSIONS: The superior transseptal approach has a higher risk of atrial tachycardia than the left atrial approach. Atrial tachycardia has different predictors than atrial fibrillation and constitutes a significant problem, especially after the superior transseptal approach. These results emphasize the need to distinguish between atrial tachycardia and atrial fibrillation—two entities with different pathophysiology, therapy, and also epidemiology.

This article has been cited by other articles:

				R. E. Eckart and L. M. Epstein Interventional Therapy for Atrial and Ventricular Arrhythmias Card. Surg. Adult, January 1, 2008; 3(2008): 1357 - 1374. [Full Text]

				P. Lukac, V. E. Hjortdal, A. K. Pedersen, P. T. Mortensen, H. K. Jensen, and P. S. Hansen Prevention of Atrial Flutter With Cryoablation May Be Proarrhythmogenic Ann. Thorac. Surg., May 1, 2007; 83(5): 1717 - 1723. [Abstract] [Full Text] [PDF]

				P. Lukac, V. E. Hjortdal, A. K. Pedersen, P. T. Mortensen, H. K. Jensen, and P. S. Hansen Superior Transseptal Approach to Mitral Valve Is Associated With a Higher Need for Pacemaker Implantation Than the Left Atrial Approach Ann. Thorac. Surg., January 1, 2007; 83(1): 77 - 82. [Abstract] [Full Text] [PDF]