RESUMO
Much importance is attached lately to the use of lasers in surgical treatment of tachyarrhythmias. The advantages of the laser radiation are as follows: the possibility of using it on a contracting heart, its exact and selective effect, infliction of even damages in preservation of the structure, reduction of damage to the myocardium as a whole. At the Bakulev Institute of Cardiovascular Surgery, USSR AMS, 52 operations were carried out in the management of supraventricular tachyarrhythmias by laser radiation: 27 operations for laser isolation of the atrioventricular node, 15 operations for laser isolation of the atria and bases of the pulmonary veins (11 in combination with laser isolation of the atrioventricular node), 3 operations for ablation of ectopic foci in the atria and ventricles, 4 operations for ablation of the bundle of His, and 3 operations for removal of Maheim's nodoventricular tract. Among the patients who were operated on, 12 had atrial flutter, 21--atrial fibrillation, 11--paroxysmal atrioventricular nodal tachycardia, 5--ectopic supraventricular tachycardia, and 3 patients had paroxysmal tachycardia due to the presence of Maheim's nodoventricular tract. The method of laser isolation of the atrioventricular node was developed. It is performed on a working heart under conditions of normothermal extracorporeal circulation by Nd-YAG laser radiation under electrophysiological control. Antegrade conductivity was reduced to 420-510 msec. Among 56 patients who underwent operation 39 had sinus rhythm, 10 had Degree II-III block, and 7 patients had a recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)
