Background
Atrial fibrillation (AF) is the most common sustained arrhythmia. About 60% of patients
with rheumatic heart disease have persistent AF.
Methods
A total of 197 patients underwent valve replacement concomitant bipolar radiofrequency
ablation (BRFA). Patients were divided into the biatrial ablation group and the simplified
right atrial ablation group. In biatrial ablation group, the patients underwent a
complete left and right atrial ablation. In simplified right atrial ablation group,
the patients underwent a complete left atrial ablation and a simplified right atrial
ablation.
Results
The conversion of sinus rhythm (SR) was high in both groups during the follow-up period.
In the simplified right atrial ablation group, SR conversion rate was 88.29% at discharge.
At six months and 12 months after surgery, 87.39% of patients and 86.49% of patients
were in SR free of antiarrhythmic drugs, respectively. While in the biatrial ablation
group, SA conversion rate was 89.53% at discharge. Percentage of patients in SR free
of antiarrhythmic drugs was 88.37% and 88.37% at six months and 12 months after surgery,
respectively. Echocardiography showed left atrial diameter decreased significantly
after the surgery in the two groups. The ejection fraction and fractional shortening
were improved significantly, without significant differences between the two groups.
Conclusions
The results suggest that the concomitant left atrial and simplified right atrial BRFA
for AF in patients undergoing valve replacement can achieve similar early efficiency
as biatrial ablation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Comparison of findings in patients with versus without atrial fibrillation just before isolated mitral valve replacement for rheumatic mitral stenosis (with or without associated mitral regurgitation).Am J Cardio. 2006; 97: 1035-1038
- Radiofrequency Ablation of Atrial Fibrillation in Patients With Mechanical Mitral Valve Prostheses.J Am Coll Cardio. 2011; 58: 596-602
- EACTS Guideline for the surgical treatment of atrial fibrillation.Eur J Cardiothorac Surg. 2013; 44: 777-791
- Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy.Euro J Cardio-Thorac Surg. 2009; 35: 641-650
- A new era in the surgical treatment of atrial fibrillation: the impact of ablation technology and lesion set on procedural efficacy.Ann Surg. 2006; 244: 583-592
- Where does atrial fibrillation surgery fail? Implications for increasing effectiveness of ablation.J Thorac Cardiovas Surg. 2010; 139: 860-867
- Efficacy of three different ablative procedures to treat atrial fibrillation in patients with valvular heart disease: a randomised trial.Heart Lung Circ. 2008; 17: 232-240
- Right atrial lesions do not improve the efficacy of a complete left atrial lesion set in the surgical treatment of atrial fibrillation, but they do increase procedural morbidity.J Thorac Cardiovas Surg. 2013; 145: 356-363
- An Effective Modification to Simplify the Right Atrial Lesion Set of the Cox-Cryomaze.Ann Thorac Surg. 2013; 96: 330-332
- Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy.Euro J Cardio-Thorac Surg. 2009; 35: 641-650
- Radiofrequency ablation of atrial fibrillation in patients with mitral or aortic mechanical prosthetic valves: A feasibility, safety, and efficacy study.Heart Rhythm. 2011; 8: 975-980
- Chronic Atrial Fibrillation Is Associated With Reduced Survival After Aortic and Double Valve Replacement.Ann Thorac Surg. 2010; 89: 738-744
- Current status of the maze procedure for the treatment of atrial fibrillation.Semin Thorac Cardiovase Surg. 2000; 12: 15-19
- Ablation technology for the surgical treatment of atrial fibrillation.ASAIO J. 2013; 59: 461-468
- Arrhythmia surgery for atrial fibrillation associated with atrial septal defect. Right-sided maze versus biatrial maze.J Thorac Cardiovas Surg. 2013; 145: 648-655
- Impact of Atrial Remodeling on Heart Rhythm After Radiofrequency Ablation and Mitral Valve Operations.Ann Thorac Surg. 2012; 93: 1449-1455
- How effective is bipolar radiofrequency ablation for atrial fibrillation during concomitant cardiac surgery?.Interact Cardiovasc Thorac Surg. 2012; 15: 741-748
- Animal studies of epicardial atrial ablation.Heart Rhythm. 2009; 6: S41-S45
- Should paroxysmal atrial fibrillation be treated during cardiac surgery?.J Thorac Cardiovasc Surg. 2013; 146: 810-823
- The effect of ablation technology on surgical outcomes after the Cox-maze procedure: a propensity analysis.J Thorac Cardiovasc Surg. 2007; 133: 389-396
- Left Atrial Ganglion Ablation as an Adjunct to Atrial Fibrillation Surgery in Valvular Heart Disease.Ann Thorac Surg. 2011; 91: 97-102
- Wide variations in energy delivery using an impedance-controlled algorithm in bipolar radiofrequency ablation: evidence against fixed time ablation.Innovations. 2007; 2: 67-72
- In patients with an enlarged left atrium does left atrial size reduction improve maze surgery success?.Interact Cardiovasc Thorac Surg. 2011; 13: 635-641
- Atrial fibrillation propagates through gaps in ablation lines: implications for ablative treatment of atrial fibrillation.Heart Rhythm. 2008; 5: 1296-1301
Article info
Publication history
Published online: February 17, 2015
Accepted:
February 8,
2015
Received in revised form:
January 26,
2015
Received:
April 9,
2014
Identification
Copyright
© 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
