Effect of the Size of the Left Atriumo Sustained Sinus Rhythm in Patients Undergoing Mitral Valve Surgery and Concomitant Bipolar Radiofrequency Ablation for Atrial Fibrillation

Abstract

Atrial fibrillation is associated with systemic embolization and complications due to anticoagulant therapy. Radiofrequency ablation has been established as an effective and safe method for the treatment of atrial fibrillation. The aim of this study was to evaluate the effect of the size of the left atrium on the outcome of surgical radiofrequency ablation. Forty patients scheduled for elective mitral valve surgery and radiofrequency ablation were enrolled in the study. Group 1 consisted of patients with a left atrium diameter ≤5 cm and group 2 of patients with left atrium diameter >5 cm. The primary endpoint of the study was stable sinus rhythm 6 months postoperatively. At 6 months postoperatively, sinus rhythm was present in significantly more group 1 patients as compared with group 2 patients, i.e. 15 (75%) vs. 8 (40%), p=0.025. Multivariate analysis proved the size of the left atrium to be an independent predictor of the radiofrequency ablation outcome. Accordingly, the size of the left atrium was demonstrated to be an important predictor of the outcome of radiofrequency ablation for atrial fibrillation. A lower cut-off value of surgical reduction of the atria than previously reported should be considered in order to improve the radiofrequency ablation outcome.

25th anniversary of the Department of Cardiac Surgery at the University Medical Center Maribor: advancing hearts, changing lives

“…We address all adult cardiac and major vascular pathologies (with exceptions such as long-term mechanical support for heart failure and transplantation activities). Our current surgical portfolio includes surgery for ischemic heart diseases (with or without cardiopulmonary bypass, multiarterial grafting, minimally invasive myocardial revascularization [ 3 , 4 ] and surgical treatment of complications, such as ventricular septal defects, myocardial ruptures and left ventricular aneurysms), aortic valve replacement with mechanical or stented bioprostheses, aortic valve repair and valve-sparing aortic root replacement (both reimplantation and remodelling with external annuloplasty) [ 5 ], minimally invasive aortic [ 6 ] and mitral valve surgery [ 7 , 8 ], mitral valve repair and replacement [ 9 ], surgical treatment of any heart valve endocarditis, surgery for tricuspid or pulmonary valve disease, aortic surgery (aortic dissection, ascending and arch aneurysms including the frozen elephant trunk procedure [ 10 ], trauma to the great vessels), surgery for atrial fibrillation [ 11 ], pericardiectomy, surgery for cardiac neoplasms, temporary mechanical circulatory support (intra-aortic balloon pump, extracorporeal membrane oxygenation) [ 12 , 13 ] and carotid endarterectomy. In addition, we provide surgical assistance and standby for various interventional cardiological (percutaneous coronary interventions, transcatheter aortic valve implantations [ 14 , 15 ], interventional treatment for atrial and ventricular arrhythmias) or radiological (thoracic endovascular aortic repair) procedures.…”

Clinical effect of total thoracoscopic mitral valve surgery combined with atrial fibrillation radiofrequency ablation in patients with different left atrium diameter—a single center prospective observational cohort study

“…Furthermore, previous studies have shown that the left atrium diameter (LAD) was an important prognostic factor for patients received mitral valve surgery and AFRA with conflicting findings. The prognosis of patients with different LAD is likely to be discrepant ( 5 - 7 ).…”