Re: Catheter Ablation After the MAZE

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Posted by steve giddings on December 10, 2002 at 14:06:25:

In Reply to: Re: Catheter Ablation After the MAZE posted by hans koster on December 10, 2002 at 11:20:37:

I will have to go back and pull my file. One of the problems is the method used in assessing atrial function. Transthoracic echo is not as sensitive as transesophageal echo in looking at the left atrium. The heart is actually rotated about a quarter turn so that the right side (atrium and ventricle) are toward the chest wall, and the left side, particularly the left atrium toward the rear.The esophagus passes diectly behind the LA. The left ventricle sort of peaks out behind the RV because it is physically bigger and thicker. The two atria are just about the same size and thickness. Cox claims that if you use TEE as the instrument 90+ % of folks get return of la function, though it is not as vigorous as prior. People who have used only TTE say 50-60%

A higher fraction get RA function back. That is really all that matters because the left side of the heart pumps all the blood that gets delivered to it (Starling's Law of the Heart), so functionally, the heart should pump as well regardless of left atrial activity.

I can't remember whether I had LA function on my first post op echo or not (just about one year). I do know that on my most recent, 1.3 years ago, it was normal.


Steve Giddings

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