Results of the surgical treatment of chronic atrial fibrillation

Abstract

Methods -

Randomized study of surgical isolation of the pulmonary veins for correction of permanent atrial fibrillation associated with mitral valve disease

“…A perpendicular incision was performed from the extended atriotomy border to the annulus of the mitral valve, dissecting the coronary sinus and performing electrocauterization as described previously. 17 The left atrial appendix was always excised, in both treatment groups. After atrial suture with 3-0 monofilament polypropylene in a single layer, the other valves were corrected if necessary.…”

“…16 This technique was modified by others, and in some reports cryoablation was not used. 17,18 More recently, Fieguth, Wahlers, and Borst 19 and Haissaguerre and colleagues 20 demonstrated that pulmonary veins, inside the left atrium, are the main focus of triggering and maintaining paroxysmal AF. In this situation and on the…”

Uso da radiofrequência bipolar para o tratamento da fibrilação atrial durante cirurgia cardíaca

“…Although the CoxMaze III surgerywith cutting and suturing technique delivers excellent short and long term results 2 both in reversion for sinus rhythm and in preventing thromboembolic events 3 , its complexity and demand for a longer surgery discouraged many surgeons to use it routinely. In our environment, the feasibility and effectiveness of the Cox Maze III have been demonstrated by Kalil et al 4 and Canale et al 5 . Aiming to simplify the procedure, several alternative forms of energy for tissue ablation resulting in bidirectional electrical conduction block were studied to recreate the original lesions of the Cox-Maze III 1 .…”

“…In our country, this is the only series of patients undergoing intervention with the use of bipolar radiofrequency. Kalil et al 4 have published their experience with the classical Cox Maze III technique in our country. In a group of 61 patients, with mean age of 49 years, mostly undergoing valve surgery after an average of one year with conventional ECG follow-up in all survivors (51 patients) and 24 h Holter monitoring in 17 patients, sinus rhythm was found in 70.5%, atrial rhythm in 4%, atrial tachycardia in 2% and DDD pacemaker rhythm in 4% The need for permanent pacemaker was 11.4%.…”