Electrophysiological Basis for Supraventricular Arrhythmias: Following Surgical Procedures for Aortic Stenosis

Harry L. Bush, Henry Gelband, Brian F. Hoffman, James R. Malm

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Abstract

Fifty-eight patients with isolated aortic stenosis who underwent open heart surgery during a three-year period had a 49% incidence of postoperative supraventricular arrhythmias (SVAs). Of the 22 patients under 20 years of age (group A), four (18%) had postoperative SVAs, in contrast to 24 of the 36 patients (66.7%) over 40 years of age (group B). The increase in SVAs in group B was due to increased frequency of atrial flutter-fibrillation. The electrophysiologic characteristics of the right atrial myocardium were normal in group A, but were markedly abnormal in group B. The diffuse spontaneous phase-4 depolarization, local conduction disturbances, and abnormal transmembrane action potential characteristics found in group B could result in multifocal ectopic pacemakers and reentry arrhythmias. Therefore, the majority of the postoperative SVAs in group B may be related to the preoperative cellular abnormalities of their right atrial myocardium.

Original languageEnglish (US)
Pages (from-to)620-625
Number of pages6
JournalArchives of Surgery
Volume103
Issue number5
DOIs
StatePublished - Nov 1971

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ASJC Scopus subject areas

  • Surgery

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