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Ann Thorac Surg. 2015 Jan;99(1):352-9. doi: 10.1016/j.athoracsur.2014.07.026. Epub 2014 Nov 15.

Prophylactic atrial arrhythmia surgical procedures with congenital heart operations: review and recommendations.

Author information

1
Johns Hopkins Children's Heart Surgery, Florida Hospital for Children, Orlando, Florida. Electronic address: constantine.mavroudis.md@flhosp.org.
2
Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
3
Inova Fairfax Hospital, Cardiac Surgery Inova Heart and Vascular Institute, Falls Church, Virginia.
4
Johns Hopkins Children's Heart Surgery, Florida Hospital for Children, Orlando, Florida.
5
Pediatric and Adult Congenital Heart Surgery, IRCSS Policlinico San Donato, San Donato M.se (MI), Italy.
6
Division of Cardiology, Peter Munk Cardiac Centre, Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada.
7
Cardiovascular-Thoracic Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
8
Division of Cardiology and the Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
9
Division of Cardiothoracic Surgery, The General Infirmary, Leeds, United Kingdom.

Abstract

Specific congenital heart anomalies significantly increase the risk for late atrial arrhythmias, raising the question whether prophylactic arrhythmia operations should be incorporated into reparative open heart procedures. Currently no consensus exists regarding standard prophylactic arrhythmia procedures. Questions remain concerning the arrhythmia-specific lesions to perform, energy sources to use, need for atrial appendectomy, and choosing a right, left, or biatrial Maze procedure. These considerations are important because prophylactic arrhythmia procedures are performed without knowing if the patient will actually experience an arrhythmia. This review identifies congenital defects with a risk for the development of atrial arrhythmias and proposes standardizing lesion sets for prophylactic arrhythmia operations.

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