EFFECTIVENESS OF UNIPOLAR RADIOFREQUENCY SURGICAL ABLATION FOR ATRIAL FIBRILLATION
https://doi.org/10.15829/1560-4071-2015-4-eng-5-8
Abstract
Aim. To verify the effectiveness of surgical ablation for atrial fibrillation by irrigated unipolar radiofrequency, applied to both atria, for the reversal and maintenance of the sinus rhythm in the short and medium term in patients undergoing concomitant cardiac surgery.
Material and methods. Between February 2008 and March 2012 a total of 35 consecutive patients with persistent and permanent paroxysmal AF underwent surgical tachyarrhythmia ablation by irrigated unipolar radiofrequency applied biatrially with concomitant cardiac surgery. All cases were diagnosed at least 12 months before the procedure and the group consisted of 15 (42,8%) male and 20 female (51,2%) patients, aged 25-78 years (52,23±12,82).
Results. There were 24 (68,5%) patients with rheumatic mitral valve disease with 25,8% with degenerative disease. The left atrial diameter measured by transthoracic echocardiography ranged from 44 to 70 millimeters (mm) (55,31±18,10).There were two hospital deaths in this series. Upon discharge, we observed the following rhythms and percentages: 24 (68,5%) — sinus rhythm, 7 (20%) — AF and 4 (11,5%) — junctional rhythm. At medium term follow-up we obtained the following results: 11 (73,3%) — sinus rhythm, 2 (13,35%) — junctional rhythm and 2 (13,35%) — AF.
Conclusion. Surgical ablation by irrigated unipolar radiofrequency applied to both atria is effective in the reversal and maintenance of sinus rhythm during short and medium term follow-up.
About the Authors
Adriano Meneghini
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
Marcelo Rodrigues Bacci
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
Neif Murad
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
Antonio Carlos Palandri Chagas
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
José Honório Palma
Department of Cardiac Surgery of UNIFESP (Federal University of São
Paulo)
Brazil
Brazil
Luiz Carlos de Abreu
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
Victor E. Valenti
Department of Cardiology of Faculdade de Medicina do ABC(ABC Medical School)
Brazil
Brazil
João Roberto Breda
Department of Cardiac Surgery of UNIFESP (Federal University of São
Paulo)
Brazil
Brazil
References
1. Wang J, Meng X, Li H. Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation. Eur J Cardiovasc Surg 2009; 35 :116-22.
2. Cox JL, Schuessler RB, D’AgostinoJr HJ. The surgical treatment of atrial fibrillation: development of a definitive surgical procedure. J Thorac Cardiovasc Surg 1991; 101: 569-83.
3. Gillinov AM, McCarthy PM, Blackstone EH. Surgical ablation of atrial fibrillation with bipolar radiofrequency as the primary modality. J Thorac Cardio vasc Surg2005; 129: 1322-9.
4. Gaynor SL, Byrd GD, Diodato MD. Microwave ablation for atrial fibrillation: doseresponse curves in the cardioplegia arrested and beating heart. Ann Thorac Surg 2006; 81: 72-6.
5. Ninet J, Roques X, Seitelberger R. Surgical ablation of atrial fibrillation with offpump, epicardical, high-intensity focused ultrasound: results of a multicenter. J Thorac Cardiovasc Surg 2005; 130:803-9.
6. Sie HT, Beukema WP, Elvan A. Long-term results of irrigated radiofrequency modified maze procedure in 200 patients with concomitant cardiac surgery: six years experience. Ann Thorac Surg 2004; 77: 512-6.
7. Viola N, Williams MR, Oz MC. The technology in use for the surgical ablation of atrial fibrillation. Semin Thorac Cardiovasc Surg 2002; 14: 198-205.
8. Gillinov AM, Bhavani S, Blackstone EH. Surgery for permanent atrial fibrillation: impact of patient factors and lesion set. Ann Thorac Surg2006; 82: 502-13.
9. Breda JR, Breda ASCR, Meneghini A. Operatory ablattion of atrial fibrillation through raiofrequency. Rev Bras Cir Cardiovasc2008; 23: 118-122.
10. Breda JR, Ragognette RG, Breda ASCR. Avaliação inicial da ablação operatória biatrial por radiofrequência de fibrilação atrial. Rev Bras Cir Cardiovasc2010; 25: 45-50.
11. Santiago T, Melo JQ, Gouveia RH. Intra-atrial temperatures in radiofrequency endocardial ablation: histologic evaluation of lesions. Ann Thorac Surg 2003; 75: 1495-1501.
12. Myrdko T, nieek-Maciejewska M, Rudziski P. Efficacy of intra-operative radiofrequency ablation in patients with permanent atrial fibrillation undergoing concomitant mitral valve replacement. Kardiol Pol 2008; 66: 932-8.
13. Johansson B, Houltz B, Berglin E. Short-term sinus rhythm predicts long-term sinus rhythm and clinical improvement after intraoperative ablation of atrial fibrillation. Europace 2008; 10: 610-7.
14. Zangrillo A, Crescenzi G, Landoni G. The effect of concomitant radiofrequency ablation and surgical technique (repair versus replacement) on release of cardiac biomarkers during mitral valve surgery. Anesth Analg 2005; 101 : 24-9.
15. Prasad SM, Maniar HS, Camillo CJ. The Cox maze III procedure for atrialfibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures. J Thorac Cardiovasc Surg 2003; 126: 1822-8.
16. Gaynor SL, Schuessler RB, Bailey MS. Surgical treatment of atrial fibrillation: predictors of late recurrence. J Thorac Cardiovasc Surg 2005; 129: 104-11.
17. Sueda T, Nagata H, Orihashi K. Efficacy of a simple left atrial procedure for chronic atrial fibrillation in mitral valve operation. Ann Thorac Surg 1997; 63: 1057-1062.
18. Maltais S, Forcillo J, Bouchard D. Long-term results following concomitant cadiofrequency modified maze ablation for atrial fibrillation J Card Surg 2010; 25: 608-13.
19. Chen Y, Maruthappu M, Nagendran M. Hoe effective is unipolar radiofrequency ablation for atrial fibrillation during concomitant cardiac surgery? Interactive CardioVascular and Thoracic Surg 2012; 1: 1-5.
20. Harada A, Konishi T, Fukata M. Intraoperative map guided operation for atrial fibrillation due to mitral valve disease. Ann Thorac Surg 2000; 69: 446-51.
21. Guden M, Akpinar B, Caynac B. Left versus biatrial intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation. Card Electrophysiol Rev 2003; 7: 252-8.
22. Pasic M, Bergs P, Muller P. Intraoperative radiofrequency maze for atrial fibrillation: the Berlim modification. Ann Thorac Surg2001; 72: 1484-91.
Review
For citations:
Meneghini A., Bacci M., Murad N., Chagas A., Palma J., de Abreu L., Valenti V., Breda J. EFFECTIVENESS OF UNIPOLAR RADIOFREQUENCY SURGICAL ABLATION FOR ATRIAL FIBRILLATION. Russian Journal of Cardiology. 2015;(4-eng):5-8. https://doi.org/10.15829/1560-4071-2015-4-eng-5-8
Views:
419
Email this article 