Intra-operative cooled-tip radiofrequency linear atrial ablation to treat permanent atrial fibrillation

Deneke, Thomas; Khargi, Krishna; Lemke, Bernd; Lawo, Thomas; Lindstaedt, Michael; Germing, Alfried; Brodherr, Turgut; Bösche, Leif; Mügge, Andreas; Laczkovics, Axel; Grewe, Peter; Fritz, Markus

doi:10.1093/eurheartj/ehm397

Cited by 22 publications

(37 citation statements)

References 22 publications

(56 reference statements)

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“…Although successful restoration of SR has been identified to increase quality of life and survival (Raanani et al 2001; Deneke et al 2007), the results of surgical cardioversion were controversial in MV patients with permanent AF (Chua et al 1994; Large et al 1997; Jessurun et al 2000; Raine et al 2004). The patients with early recurrence of AF have more advanced pathological changes in the atria and may be good candidates for concomitant anti-AF procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Because of limited success of electrical- and/or drug-induced conversion, concomitant maze procedure and intraoperative radiofrequency ablation have been used during the past two decades (Raanani et al 2001; Deneke et al 2007). However, it remains a significant concern for the inevitable risk of perioperative complications and uncertainty regarding atrial mechanical function (Cox et al 2000; Boyd et al 2009).…”

Section: Introductionmentioning

confidence: 99%

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Heat shock proteins in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery

Cao

Xue

et al. 2011

Cell Stress and Chaperones

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A spontaneously restored sinus rhythm in permanent atrial fibrillation patients has been often observed after mitral valve (MV) surgery, but persisting duration in sinus rhythm varies from patient to patient. Heat shock proteins (Hsps) may be involved in pathogenesis of atrial fibrillation. We hypothesized that stabilization of restored sinus rhythm is associated with expression of Hsps in the atria. To test this hypothesis, clinical data, biopsies of right atrial appendage, and blood samples were collected from 135 atrial fibrillation patients who spontaneously restored sinus rhythm after conventional isolated MV replacement. Comparison was made between patients who had recurrence of atrial fibrillation within 7 days (AF) vs. patients with persisted sinus rhythm for more than 7 days (SR). Results showed that SR patients had higher activity of heat shock transcription factor 1 (HSF1) as well as upregulated expressions of heat shock cognate 70, Hsp70, and Hsp27 in the tissues. The activation of HSF1–Hsps pathway was associated with less-aggressive pathogenesis as reflected by lower rates of myolysis, apoptosis, interstitial fibrosis, and inflammation in SR patients. However, Hsp60 was lower in both tissue and plasma in SR patients, and was positively correlated with apoptosis, interstitial fibrosis, and inflammation. These findings suggest that the Hsps play important roles in stabilization of restored sinus rhythm after MV surgery by inhibiting AF-related atrial remodeling and arrhythmogenic substrates in atrial fibrillation patients. Low circulating Hsp60 levels preoperatively might predict a stable spontaneously restored sinus rhythm postoperatively.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heat shock proteins in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery

Cao

Xue

et al. 2011

Cell Stress and Chaperones

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“…Because of the limited success of electrical and/or drug-induced conversion, concomitant maze procedure and intraoperative radiofrequency ablation have been used during the past two decades [1,3]. However, significant concern remains given the inevitable risk of perioperative complications and uncertainty regarding atrial mechanical function [4,5].…”

Section: Introductionmentioning

confidence: 99%

OPG/RANK/RANKL Axis in Stabilization of Spontaneously Restored Sinus Rhythm in Permanent Atrial Fibrillation Patients after Mitral Valve Surgery

Liu¹,

Cao

Zhu³

et al. 2012

Cardiology

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Objective: To investigate the expression of the osteoprotegerin (OPG)/receptor activator of nuclear factor-ĸB (RANK)/RANK ligand (RANKL) axis in the stabilization of spontaneously restored sinus rhythm (SR) in permanent atrial fibrillation (AF) patients after mitral valve (MV) surgery and study its clinical significance. Methods: Clinical data, biopsies of right atrial appendages were collected from 135 permanent AF patients who spontaneously restored SR after conventional isolated MV replacement. A comparison was made between patients who had recurrence of AF within 7 days and patients with persistent SR for more than 7 days. Results: AF patients had an increased expression of RANK, RANKL, and the RANKL/OPG ratio compared to SR patients, and the degree of fibrosis was lower in SR compared to AF in the atria. Moreover, the expressions of RANK, RANKL, and the RANKL/OPG ratio were positively correlated with the degree of fibrosis. Conclusion: These findings suggest that the OPG/RANK/RANKL axis plays important roles in the stabilization of restored SR after MV surgery by stimulating AF-related atrial remodeling in AF patients.

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“…In this patient collective, the incidence of AF is determined mainly by the underlying cardiac pathology 1 . Surgical therapy of AF added to the indicated cardiac surgical procedure, as a concomitant AF surgery, has been documented to effectively restore sinus rhythm (SR) even in patients with long‐lasting AF 2 . In recent studies, it was shown that the technical modalities to intraoperatively treat AF (surgical cut‐and‐sew maze, modified surgery using radiofrequency ablation, cryo‐ablation) do not influence rhythm success 3 .…”

Section: Introductionmentioning

confidence: 99%

Long‐Term Sinus Rhythm Stability after Intraoperative Ablation of Permanent Atrial Fibrillation

Deneke

Khargi

Voss

et al. 2009

Pacing Clinical Electrophis

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Intra-operative cooled-tip radiofrequency linear atrial ablation to treat permanent atrial fibrillation

Cited by 22 publications

References 22 publications

Heat shock proteins in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery

Heat shock proteins in stabilization of spontaneously restored sinus rhythm in permanent atrial fibrillation patients after mitral valve surgery

OPG/RANK/RANKL Axis in Stabilization of Spontaneously Restored Sinus Rhythm in Permanent Atrial Fibrillation Patients after Mitral Valve Surgery

Long‐Term Sinus Rhythm Stability after Intraoperative Ablation of Permanent Atrial Fibrillation

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