Left Atrial Radiofrequency Ablation Associated with Valve Surgery: Midterm Outcomes

被引:5
作者
Nardi, Paolo [1 ]
Mvondo, Charles Mve [1 ]
Scafuri, Antonio [1 ]
Pellegrino, Antonio [1 ]
D'Auria, Francesca [1 ]
Polisca, Patrizio [1 ]
Zeitani, Jacob [1 ]
Chiariello, Luigi [1 ]
机构
[1] Policlin Univ Tor Vergata, Div Cardiac Surg, I-00133 Rome, Italy
关键词
atrial fibrillation; mitral valve surgery; aortic valve surgery; radiofrequency ablation; MAZE PROCEDURE; SURGICAL-TREATMENT; FIBRILLATION; EFFICACY; DISEASE; IMPACT;
D O I
10.1055/s-0032-1322606
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Left atrial ablation is a surgical standard technique for the treatment of persistent or chronic atrial fibrillation (p-AF and c-AF, respectively). Objective The aim of the study is to evaluate midterm results of left atrial ablation according to modified Maze procedure in patients affected by p-AF or c-AF and concomitant mitral or aortic valve disease requiring surgical treatment. Methods A total of 108 patients (age, mean +/- standard deviation [SD]: 66 +/- 8.5 years) underwent left atrial ablation by means of unipolar (n = 62) or bipolar (n = 66) radiofrequency for p-AF (n = 28) or c-AF (n = 100) in association with mitral (n = 93) or mitral and aortic valve (n = 35) surgery. Results In-hospital mortality was 0.8%. Patients with preoperative c-AF had preoperative greater value of left atrial diameter (56.7 +/- 7.4 vs. 52 +/- 9 mm, p = 0.05) than those with p-AF. At 9 years after Maze procedure, 86% (n = 24/28) of patients with preoperative p-AF were in sinus rhythm versus 28% (n = 27/95) with c-AF (p < 0.0001). Preoperative c-AF and left atrial diameter of 75 mm or more predicted atrial fibrillation recurrence. In patients in sinus rhythm compared with those in residual atrial fibrillation, survival was 100 versus 86% +/- 6.4%, New York Heart Association class was 1.3 +/- 0.5 versus 1.7 +/- 0.6, and need of lifelong anticoagulation therapy was 43 versus 91% (p < 0.05, for all comparisons). Conclusions Left atrial Maze procedure for p-AF offers better chances to conversion in sinus rhythm as compared with long-standing c-AF. Survival, functional status, and quality of life are superior in patients who benefit from sinus rhythm.
引用
收藏
页码:392 / 397
页数:6
相关论文
共 50 条
  • [21] Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy
    von Oppell, Ulrich O.
    Masani, Navroz
    O'Callaghan, Peter
    Wheeler, Richard
    Dimitrakakis, Georgios
    Schiffelers, Sandra
    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2009, 35 (04) : 641 - 650
  • [22] Acute effects of left atrial radiofrequency ablation on atrial fibrillation
    Scharf, C
    Oral, H
    Chugh, A
    Hall, B
    Good, E
    Cheung, P
    Pelosi, F
    Morady, F
    JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, 2004, 15 (05) : 515 - 521
  • [23] Iatrogenic atrial septal defect post radiofrequency ablation in patients with left atrial SVT: Predictors and outcomes
    Al-Alwany, Ameen
    REVISTA LATINOAMERICANA DE HIPERTENSION, 2021, 16 (03): : 185 - 191
  • [24] Radiofrequency Ablation of Atrial Fibrillation in Patients With Mechanical Mitral Valve Prostheses Safety, Feasibility, Electrophysiologic Findings, and Outcomes
    Hussein, Ayman A.
    Wazni, Oussama M.
    Harb, Serge
    Joseph, Lee
    Chamsi-Pasha, Mohammed
    Bhargava, Mandeep
    Martin, David O.
    Dresing, Thomas
    Callahan, Thomas
    Kanj, Mohamed
    Natale, Andrea
    Lindsay, Bruce D.
    Saliba, Walid I.
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 58 (06) : 596 - 602
  • [25] Short-term and mid-term effects of radiofrequency ablation in mitral valve surgery in patients with different left atrial sizes
    Yao, Ming-Hui
    Ren, Chong-Lei
    Zhang, Lin
    Li, Liang-Gang
    Jiang, Sheng-Li
    JOURNAL OF THORACIC DISEASE, 2020, 12 (10) : 6030 - 6038
  • [26] Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery
    Brick, Alexandre Visconti
    Braile, Domingo M.
    BRAZILIAN JOURNAL OF CARDIOVASCULAR SURGERY, 2017, 32 (01) : 22 - 28
  • [27] Ablation surgery failure after combined permanent atrial fibrillation ablation and mitral valve surgery
    Geidel, S.
    Lass, M.
    Jensen, F.
    Hassan, K.
    Boczor, S.
    Kuck, K. -H.
    Ostermeyer, J.
    Schneider, C.
    THORACIC AND CARDIOVASCULAR SURGEON, 2008, 56 (04) : 185 - 189
  • [28] Impact of Metabolic Syndrome on Left Atrial Electroanatomical Remodeling and Outcomes After Radiofrequency Ablation of Nonvalvular Atrial Fibrillation
    Dinov, Borislav
    Kosiuk, Jedrzej
    Kircher, Simon
    Bollmann, Andreas
    Acou, Willem-Jan
    Arya, Arash
    Hindricks, Gerhard
    Rolf, Sascha
    CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2014, 7 (03) : 483 - 489
  • [29] Rhythmic and haemodynamic determinants of long-term survival after radiofrequency ablation of atrial fibrillation in mitral valve surgery
    Rostagno, Carlo
    Gelsomino, Sandro
    Stefano, Pier Luigi
    Padeletti, Luigi
    EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES, 2016, 2 (04) : 285 - 290
  • [30] The effect of left atrial remodeling after cryoballoon ablation and radiofrequency ablation for paroxysmal atrial fibrillation
    Wang, Xule
    Song, Beibei
    Qiu, Chunguang
    Han, Zhanying
    Wang, Xi
    Lu, Wenjie
    Chen, Xiaojie
    Chen, Yingwei
    Pan, Liang
    Sun, Guoju
    Qin, Xiaofei
    Li, Ran
    CLINICAL CARDIOLOGY, 2021, 44 (01) : 78 - 84