An Atypical Presentation of Right Atrial Flutter Following the Cox Maze Procedure and Left Atrial Reduction Surgery: A Case Report.

The onset of recurrent atrial tachyarrhythmia (ATA) following the Cox maze procedure (CMP) is commonly encountered, and may be associated with increased perioperative mortality. The majority of recurrent ATA cases are localized to the left atrium following surgical ablation. Right atrial flutter (AFL) following the CMP is a less-frequent occurrence, and may pose a diagnostic challenge due to uncharacteristic surface electrocardiogram (ECG) and intracardiac activation patterns.

Ventricular fibrillation resulting from diaphragmatic stimulation during gastric bypass surgery.

Objective: Gastric bypass operations are common and severely obese patients are prone to arrhythmias, particularly atrial fibrillation. Intraoperative ventricular arrhythmias during bariatric surgery have not been reported previously.

Case Report: A 35-year-old, severely obese, diabetic woman with no other prior medical history underwent thorough preoperative cardiovascular evaluation before having laparoscopic Roux-en-Y gastric bypass.

Real-time monitoring of luminal esophageal temperature during left atrial radiofrequency catheter ablation for atrial fibrillation: observations about esophageal heating during ablation at the pulmonary vein ostia and posterior left atrium.

Introduction: Left atrial radiofrequency catheter ablation (RFA) is gaining acceptance as treatment for drug-refractory atrial fibrillation (AF). This therapy has been associated with esophageal injury and atrioesophageal fistula formation causing death.

Methods: We describe 3 patients undergoing catheter ablation for AF during real-time monitoring of luminal esophageal temperature.

The buddy wire technique: accessing lateral coronary veins while maintaining coronary sinus position.

There is compelling data to place the coronary sinus lead (CSL) in a lateral or posterolateral tributary. Coronary sinus venography often demonstrates the absence of easily accessible lateral veins or those with sufficient size to accommodate the CSL. The operator may choose to deploy the CSL in the anterior vein but publications and experience highlight the lack of resynchronization benefit when the CSL is deployed in this location.

Increased P-wave dispersion predicts recurrent atrial fibrillation after cardioversion.

Atrial fibrillation (AF) will recur in a number of patients treated with cardioversion. Being able to identify reliable risk factors would be useful for making management decisions. P-wave dispersion (PWD) is an electrocardiographic measurement, which reflects a disparity in atrial conduction.

Implantation of implantable cardioverter-defibrillators from an ileofemoral approach.

Patients needing an implantable cardioverter defibrillator (ICD) system, but without suitable access from jugular or subclavian routes present a vexing problem. Such patients would normally undergo thoracotomy for epicardial lead placement. However, for patients who decline such an intervention, there have been no alternatives for them.

Electrical storm after coronary artery bypass grafting due to a kinked left internal mammary artery graft.

Ischemic postoperative ventricular arrhythmias may complicate coronary artery bypass surgery, and may be difficult to treat unless the ischemic substrate is rescued. This report describes a case of a kinked graft that caused incessant polymorphic ventricular arrhythmia. The treatment was surgical correction of the crook.

Incidence and predictors of atrial fibrillation after aortic repairs.

The incidence of atrial fibrillation and the clinical predictors for its development were studied in 153 patients who underwent thoracic and abdominal aortic repair.