Shelly C. Lall, MD, Kelley V

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Presentation transcript:

Pulmonary vein isolation and the Cox maze procedure only partially denervate the atrium Shelly C. Lall, MD, Kelley V. Foyil, MS, Shun-Ichiro Sakamoto, MD, Rochus K. Voeller, MD, John P. Boineau, MD, Ralph J. Damiano, MD, Richard B. Schuessler, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 135, Issue 4, Pages 894-900 (April 2008) DOI: 10.1016/j.jtcvs.2007.11.044 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Modified Cox maze lesion set. SVC, Superior vena cava; IVC, inferior vena cava. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Calculation of change in QRST area for unipolar electrographic analysis. Stim, Stimulation. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Change in heart rate and atrioventricular interval. ∗P ≤ .05. AV, Atrioventricular; RVST, right vagosympathetic trunk; LVST, left vagosympathetic trunk; PVI, pulmonary vein isolation; CM, Cox maze procedure. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Global percentage change in QRST area. Values after stimulation, PVI, and the Cox maze procedure are significantly different (P ≤ .05) from control values in each of the 4 nerves for both sympathetic and parasympathetic stimulation. ∗P ≤ .05. RVST, Right vagosympathetic trunk; LVST, left vagosympathetic trunk; PVI, pulmonary vein isolation; CM, Cox maze procedure. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Right and left atrial percentage change in QRST area. ∗P ≤ 0.05. RVST, Right vagosympathetic trunk; LVST, left vagosympathetic trunk; PVI, pulmonary vein isolation; CM, Cox maze procedure. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Right versus left atrial percentage change in QRST area. ∗P ≤ 0.05. R, Right; L, left; RVST, right vagosympathetic trunk; LVST, left vagosympathetic trunk; Stim, stimulation; PVI, pulmonary vein isolation; CM, Cox maze procedure. The Journal of Thoracic and Cardiovascular Surgery 2008 135, 894-900DOI: (10.1016/j.jtcvs.2007.11.044) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions