[Evaluation of the results of epicardial electric pulse destruction of the bundle of Kent: immediate and late results]

Abstract

The authors assessed the outcomes of an epicardial electrical pulse destructive operation on Kent's bundle in 170 patients with the Wolff-Parkinson-White syndrome. The operation consisted in generating an electrical stimuli train of a power of 50-250 J along the fatty tenial margin of the atrioventricular sulcus, which damaged or isolated Kent's bundle. By refining the indications for application of the method, the authors succeeded in achieving 98% efficacy in abolishing the Kent bundle conduction in the absence of deaths in the latter group of patients. The technique was found to be indicated in lateral bundle localizations, except right anterolateral localizations when atrioventricular conduction disturbances may be present. Myocardial changes occurring after destruction caused no hemodynamic abnormalities and were not associated with coronary artery lesions. Increasing the force of intact myocardial contraction fully compensated a slight segmental ejection fraction deficiency at the site of destruction.