Evaluation of clinical treatment of atrial fibrillation associated with rheumatic mitral valve disease by radiofrequency ablation

OBJECTIVES: The aim of this clinical study was to evaluate the effectiveness and advantages of the radiofrequency ablation maze procedure in the treatment of atrial fibrillation associated with rheumatic mitral valve disease. METHODS: We developed one kind of modified Cox III maze procedure with the use of radiofrequency ablation in the treatment of atrial fibrillation associated with rheumatic mitral valve disease and compared the outcome of 96 patients of atrial fibrillation associated rheumatic mitral valve disease who underwent radiofrequency ablation maze procedure plus mitral valve replacement with that of 87 patients with atrial fibrillation associated rheumatic mitral valve disease who had mitral valve replacement during the same interval by the same surgeon. The patients in the two groups were similar in age, gender, preoperative New York Heart Association class and duration of preoperative atrial fibrillation. RESULTS: No operative deaths occurred in the study group and the control group. Duration of cardiopulmonary bypass (137.63 +/- 10.82 vs. 90.95 +/- 7.65 min, P<0.01) and duration of aortic crossclamping (56.96 +/- 6.19 vs. 32.66 +/- 3.55 min, P<0.01) were prolonged in the study group. Blood loss from chest tubes was similar in the two groups (494.06 +/- 100.44 vs. 476.09 +/- 115.84 ml, P=0.263). Freedom from atrial fibrillation in the study group was 77% 3 years after the operation compared with 25% in the control group (P<0.01). CONCLUSIONS: The addition of the radiofrequency ablation maze procedure to mitral valve replacement is safe and effective in the treatment of atrial fibrillation associated with rheumatic mitral valve disease.