García-Villarreal OA

Language: English
References: 5
Page: 134-134
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ABSTRACT

I thank the authors the kind response to my previous letter. However, the critical mass concept in a large left atrium needs to be clarified. As I stated in my previous letter, “atrial remodeling with an increase in atrial fibrosis is a pathologic condition in which the conduction velocity as well the effective refractory periods (ERP) can be shortened in both atria”. That means to say, slower conduction velocities. Indeed, Falk has shown that atrial remodeling, with increased atrial fibrosis, can result in slow conduction velocities as well as shorten refractory periods, especially in long-standing AF.

REFERENCES

1. McGilvray MMO, Damiano RJ Jr. Reply: The best patient for the operation, or the bestoperation for the patient?. J Thorac Cardiovasc Surg (2023). ([Epub ahead of print]).doi: 10.1016/j.jtcvs.2023.02.020.

2. García-Villarreal OA. The importance of the critical mass concept in the Cox-mazeprocedure. J Thorac Cardiovasc Surg. 2023 Jan 4:S0022-5223(22)01343-5. doi:10.1016/j.jtcvs.2022.12.007.

3. Falk RH. Atrial fibrillation. N Engl J Med. 2001;344(14):1067-78. doi: 10.1056/NEJM200104053441407.

4. Falk RH. Etiology and complications of atrial fibrillation: insights from pathologystudies. Am J Cardiol. 1998;82(8A):10N-17N. doi: 10.1016/s0002-9149(98)00735-8.

5. Byrd GD, Prasad SM, Ripplinger CM, Cassilly TR, Schuessler RB, Boineau JP, DamianoRJ Jr. Importance of geometry and refractory period in sustaining atrial fibrillation:testing the critical mass hypothesis. Circulation. 2005;112(9 Suppl):I7-13. doi:10.1161/CIRCULATIONAHA.104.526210.