Intraoperative radiofrequency ablation during mitral valve surgery resulted in 76% of surviving patients remaining in sinus rhythm at a mean follow-up of 20 months.
Observational (n=72)
Does intraoperative radiofrequency ablation restore sinus rhythm in patients with mitral valve disease and long-standing atrial fibrillation undergoing open-heart surgery?
Intraoperative radiofrequency ablation during mitral valve surgery is an effective, less invasive alternative to the traditional maze procedure for restoring sinus rhythm in patients with long-standing atrial fibrillation.
OBJECTIVE: Patients with mitral valve disease and suffering of atrial fibrillation of more than 1 year's duration have a low probability of remaining in sinus rhythm after valve surgery alone. Intraoperative radiofrequency ablation was used as an alternative to simplify the surgical maze procedure. METHODS: Seventy-two patients with mitral valve disease, aged 63+/-11 years ranging from 31 to 80 years, underwent valve surgery and radiofrequency energy applied endocardially, based on the maze III procedure to eliminate the arrhythmia. The right-sided maze was performed on the beating heart and the left-sided maze during aorta cross-clamping. RESULTS: Surgical procedures included mitral valve repair (n=38) or replacement (n=34) and in addition tricuspid valve repair (n=42), closure of an atrial septal defect (n=2) and correction of cor triatriatum (n=1). The left-sided maze needed 14+/-3 min extra ischemic time. There were two in-hospital deaths (2.7%) and three patients (4.2%) died during follow-up of 20+/-15 months. Among 67 surviving patients, 51 patients (76%) were in sinus rhythm, two patients (3%) had an atrial rhythm and eight patients (12%) had persistent atrial fibrillation or atrial flutter. Four patients had a pacemaker implanted, in one patient because of sinus node dysfunction. Doppler echocardiography in 64 patients demonstrated right atrial contractility in 89% and left atrial transport in 91% of patients. CONCLUSIONS: Intraoperative radiofrequency ablation of atrial fibrillation is an effective and less invasive alternative for the original maze procedure to eliminate atrial fibrillation.
Sie et al. (Sun,) conducted a observational in Mitral valve disease and atrial fibrillation (n=72). Intraoperative radiofrequency ablation (modified maze procedure) was evaluated on Sinus rhythm at follow-up. Intraoperative radiofrequency ablation during mitral valve surgery resulted in 76% of surviving patients remaining in sinus rhythm at a mean follow-up of 20 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: