Tratamento da fibrilação atrial com ablação por ultrassom, durante correção cirúrgica de doença valvar cardíaca

Lins, Rosaly Moraes Marques; Lima, Ricardo de Carvalho; Silva, Frederico Pires Vasconcelos; Menezes, Alexandre; Salerno, Pedro Rafael; Sepúlveda, Diana; Albuquerque, Eugenio Soares de

doi:10.1590/s0102-76382010000300008

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…The success rate of CAF reversal of this study is compared to that of other authors [15,20,26] , using various energy sources and techniques, such as radiofrequency, cryoablation, and US, and performing the atrial ablation lines in the same way.…”

Section: Discussionmentioning

confidence: 94%

“…Lins et al [20] , when comparing patients undergoing US ablation to those who did not, found that 80% of the patients treated with US were free of AF whereas, in the other group, that occurred to only 30% of the patients. The results observed in this study are similar to those obtained in the study presented herein, showing that US ablation can be applied in patients with surgical indication for mitral valve disease repair.…”

Section: Discussionmentioning

confidence: 99%

“…New energy sources capable of causing permanent blockage lines have been used [13] such as radiofrequency [14-18] , microwave [19] (90=17), and ultrasound (US) [20,21] .…”

Section: Introductionmentioning

confidence: 99%

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Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Brick

Braile

2017

Braz J Cardiovasc Surg

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ObjectiveTo evaluate surgical treatment of chronic atrial fibrillation with ultrasound in patients with mitral valve disease, considering preoperative clinical characteristics of patients undergoing surgical procedure and follow-up in the immediate postoperative period, in hospital and up to 60 months after discharge.MethodsWe studied 100 patients with chronic atrial fibrillation and mitral valve disease who underwent surgical treatment using ultrasound ablation. Patient data were reviewed by consulting the control reports, including signs and symptoms, underlying disease, functional class, hospital stay, surgical procedure time, ablation time, immediate complications, and complications at discharged and up to 60 months later. Actuarial curve (Kaplan-Meier) was used for the study of permanence without recurrence after 12, 24, 36, 48 and 60 months.Results86% of the patients had rheumatic mitral valve disease, 14% had degeneration of the mitral valve, 40% had mitral regurgitation, and 36% had mitral stenosis. Main symptoms included palpitations related to tachycardia by chronic atrial fibrillation (70%), congestive heart failure (70%), and previous episodes of acute pulmonary edema (27%). Early results showed that 94% of the patients undergoing ultrasound ablation reversed the rate of chronic atrial fibrillation, 86% being in sinus rhythm and 8% in atrioventricular block. At hospital discharge, maintenance of sinus rhythm was observed in 86% of patients and there was recurrence of chronic atrial fibrillation in 8% of patients. At follow-up after 60 months, 83.8% of patients maintained the sinus rhythm.ConclusionSurgical treatment of chronic atrial fibrillation with ultrasound concomitant with mitral valve surgery is feasible and satisfactory, with maintenance of sinus rhythm in most patients (83.8%) after 60 months of follow-up.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Brick

Braile

2017

Braz J Cardiovasc Surg

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“…Lins et al [21] report that the cardioversion of atrial fibrillation to sinus rhythm in the immediate postoperative period was 20 (90.9%) from 22 patients in the group receiving ablation versus 3 (13.6%) of the 22 patients group which were not submitted to ablation.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Chronic Atrial Fibrillation During Surgery for Rheumatic Mitral Valve Disease

Gonçalves¹,

Leite²,

Leite³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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IntroductionThe result of surgical ablation of atrial fibrillation remains controversial, although prospective and randomized studies have shown significant differences in the return to sinus rhythm in patients treated with ablation versus control group. Surgery of the Labyrinth, proposed by Cox and colleagues, is complex and increases the morbidity rate. Therefore, studies are needed to confirm the impact on clinical outcomes and quality of life of these patients.ObjectiveTo analyze the results obtained in the treatment of atrial fibrillation by surgical approach, by Gomes procedure, for mitral valve surgery in patients with rheumatic heart disease associated with chronic atrial fibrillation.MethodsWe studied 20 patients with mitral valve dysfunction of rheumatic etiology, evolving with chronic atrial fibrillation, submitted to surgical treatment of valvular dysfunction and atrial fibrillation by Gomes procedure.ResultsThe mean duration of infusion ranged from 65.8±11.22 and aortic clamping of 40.8±7.87 minutes. Of 20 patients operated, 19 (95%) patients were discharged with normal atrial heart rhythm. One (5%) patient required permanent endocardial pacing. In the postoperative follow-up of six months, 18 (90%) patients continued with regular atrial rhythm, one (5%) patient returned to atrial fibrillation and one (5%) patient continued to require endocardial pacemaker to maintain regular rhythm.ConclusionGomes procedure associated with surgical correction of mitral dysfunction simplified the surgical ablation of atrial fibrillation in patients with rheumatic mitral valve disease and persistent atrial fibrillation. The results showed that it is a safe and effective procedure.

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“…The use of this technology has attracted interest because it allows ablation non-invasively and without contact with the focal tissue, decreasing the chance of affecting surrounding structures [36,37].…”

Section: High-intensity Ultrasoundmentioning

confidence: 99%

Tratamento operatório da fibrilação atrial

Breda¹,

Ribeiro²

2011

Rev Bras Cir Cardiovasc

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When atrial fibrillation (AF) is present in pre-operative open heart surgeries, including coronary artery bypass grafting and valve operations, it represents an independent risk factor for cardiac events and reduced survival. Due to the complexity of the subject, especially when evaluating success rates (reversion and maintenance of normal sinus rhythm), a consensus statement was recently proposed by the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS), in order to determine whether the intraoperative ablation of AF promotes favorable clinical outcomes in patients undergoing other cardiac operations in comparison with individual operations without ablation. The aim of this paper is to present published data which has contributed to consensus statement and can be useful as update source. The integrative review was the methodology that provides synthesis of knowledge and applicability of results of significant studies about presented topic. Descriptors

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Tratamento da fibrilação atrial com ablação por ultrassom, durante correção cirúrgica de doença valvar cardíaca

Cited by 12 publications

References 19 publications

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Treatment of Chronic Atrial Fibrillation During Surgery for Rheumatic Mitral Valve Disease

Tratamento operatório da fibrilação atrial

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