Mapping-guided total excision of the sinoatrial node for inappropriate sinus tachycardia

Abstract

heart syndrome, with 98% of patients demonstrating a neoaortic dilation with a z score greater than 2 at a median of 9.2 years of follow-up. 5 The etiology of neoaortic aneurysm formation may involve myxoid degeneration as opposed to atherosclerosis 3 ; however, it is unclear whether any contributing factors exist (eg, hypertension, hyperlipidemia, smoking status, pregnancy) and whether medical therapy can mitigate them.Given that the rate of aneurysmal growth of the neoaorta appears unpredictable and smaller aneurysms may be asymptomatic, it is difficult to determine when a routine surveillance program should be initiated, although it is clear that routine lifetime surveillance is needed for these patients. Routine, long-term surveillance of late survivors of Norwood reconstructions may also shed light on the true incidence and natural history of neoaortic aneurysm formation in this population.

Late Outcomes of Surgical Ablation for Inappropriate Sinus Tachycardia

“…This lesion resolved the patient’s tachycardia and replaced it with a stable junctional escape rhythm. 21 Similar techniques used to completely isolate the SA node were reported in case reports 22,23 and a case series by Hendry and colleagues 24 Both case reports noted symptomatic relief and freedom from medications up to 1 year postoperatively, 22,23 whereas Hendry and colleagues 24 reported that 1 of 3 patients in their series with sinus tachycardia was in sinus rhythm several years postoperatively. With the advent of ablation technology, cryoablation and bipolar RF energy are used to avoid surgical incisions, shorten the operative time, and avoid cardiopulmonary bypass.…”