Simple Left Atrial Procedure for Chronic Atrial Fibrillation Associated With Mitral Valve Disease

Sueda, Taijiro; Nagata, Hideyuki; Shikata, Hiroo; Orihashi, Kazumasa; Morita, Satoru; Sueshiro, Masafumi; Okada, Kenji; Matsuura, Yuichiro

doi:10.1016/s0003-4975(96)00613-3

Cited by 167 publications

(110 citation statements)

References 13 publications

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“…Repetitive activity with variable cycle length was found in the LA and RA of AF patients. 29,30 Other studies 31,32 have demonstrated unstable reentrant circuits or driver activity, which could be interpreted as causing fibrillatory conduction. A strong argument has been made that most patients with AF may have a focal mechanism as the initiating cause of the arrhythmia.…”

Section: Are There Rotors In the Human Atrium?mentioning

confidence: 98%

Cardiac fibrillation: From ion channels to rotors in the human heart

Vaquero¹,

Calvo²,

Jalife³

2008

Heart Rhythm

158

134

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Cardiac fibrillation is one of the most important causes of morbidity and mortality in the developed world, but its mechanisms are still a matter of debate. Not only is the role of certain ion channels currently being unraveled, but also investigators are starting to gather evidence for the dynamics and molecular mechanisms of both atrial (AF) and ventricular (VF) fibrillation in humans. In this brief review, we evaluate the available evidence for the separate roles played by individual sarcolemmal ion channels in AF and VF, assessing the clinical relevance of such findings. Importantly, while human data support the idea that rotors are a crucial mechanism for fibrillation maintenance in both the atria and the ventricles, there are clear inherent differences between the two chamber types, particularly in regards to the role of specific ion channels in fibrillation. But there are also similarities. This knowledge, together with new information on the changes that take place during disease evolution and between structurally normal and diseased hearts may enhance our understanding of fibrillatory processes pointing to new pharmacological or interventionist approaches to improve disease outcomes.

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Section: Are There Rotors In the Human Atrium?mentioning

confidence: 98%

Cardiac fibrillation: From ion channels to rotors in the human heart

Vaquero¹,

Calvo²,

Jalife³

2008

Heart Rhythm

158

134

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“…The introduction of a bipolar radiofrequency ablation device for the maze procedure made the maze procedure easy to perform, and it has been adopted as the standard AF procedure now. 7) We previously developed the simple left atrial procedure 8,9) to ablate only the posterior wall of the left atrium against chronic AF. Our previous study reported the long-term results of the simple left atrial procedure for chronic AF associated with mitral valve disease.…”

Section: Discussionmentioning

confidence: 99%

“…7) Our previous study performed on mitral valve disease showed a shortened refractory period for the left atrial wall, and that the simple left atrial procedure was adequate in eliminating the AF associated with isolated mitral disease. 8) We performed the simple left atrial procedure for chronic AF during mitral valve surgery from 1993 to 1998, 9) and reported our mid-term 10) and long-term 11) results. Following the discovery by Haissaguerre and colleagues, 12) the etiology of paroxysmal AF was well investigated.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results after the Box Pulmonary Vein Isolation Procedure for Chronic Atrial Fibrillation in Mitral Valve Surgery

Sueda

Uchida

Takasaki

et al. 2012

ATCS

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Background: We hypothesized that chronic atrial fibrillation (AF) originated from the pulmonary veins, and was maintained by irregular activations of the posterior left atrium. We had performed the box pulmonary vein isolation procedure for the elimination of chronic AF associated with solitary mitral valve disease from 1999 to 2004. This paper evaluated the long-term results of this procedure over more than 6 years, and discussed the role of the pulmonary veins and posterior left atrium in maintaining AF. Methods: Fifty-three patients were examined after box pulmonary vein isolation procedure concomitant with solitary mitral valve surgery retrospectively. We divided the patients into two groups with or without the elimination of AF (AF group and non-AF group). The disappearance of AF was determined by electrocardiography, and atrial function was evaluated by transthoracic echocardiography. The elimination of chronic AF and the recovery of atrial systolic function after surgery were evaluated over more than 6 years of follow-up. Results: In a total of 462.8 patient years of follow-up (range 6.3 to 11.5 years, mean: 8.9 ± 2.7 years), AF disappeared in 77.3% of the patients (41/53) at 3 months and in 70.6% (36/51) of the patients at 6 years after the box pulmonary vein isolation, respectively. Among the preoperative variables, a long duration of AF and a large diameter of the left atrium were the predictive factors for recurrences of AF (p <0.05). There was no left atrial tachycardia even though we did not perform ablation towards the mitral valve annulus. Conclusions: The box pulmonary vein isolation procedure can terminate chronic AF associated with solitary mitral valve disease, and maintain a sinus rhythm for more than 6 years in 70% of chronic AF patients. This study implicates the pulmonary veins and posterior left atrium in maintaining chronic AF associated with mitral valve disease.

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“…Sie et al [8] have obtained reversal to sinus rhythm in 79% of the patients who underwent application of biatrial radiofrequency in a mean follow-up of 40 months. Sueda et al [9] with isolation the left atrium only, without right atrium incisions in patients with permanent AF, have obtained an AF-free rate of 74% during a 3 year-follow-up period. In 2008, we have published an initial experience using uniatrial radiofrequency in 15 patients with a successful rate of 60% at hospital discharge and 46.7% during mean follow-up of these patients [7].…”

Section: Discussionmentioning

confidence: 99%

Avaliação inicial da ablação operatória biatrial por radiofrequência de fibrilação atrial

Breda¹,

Ragognette²,

Breda³

et al. 2010

Rev Bras Cir Cardiovasc

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Objective: The aim of this study is to evaluate the initial results of intraoperative radiofrequency ablation using biatrial procedure to treat chronic atrial fibrillation in patients with associated cardiac disease.Methods: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 ± 9.85 years and 60% were male. The mean left atrial diameter was 55.06 ± 7.56 mm.Results: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 ± 4 months. At the time of hospital discharge 9 (60%) patients were in sinus rhythm. After a mean follow-up period 11 (73.3%) were in sinus rhythm.Conclusion: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm. Bras Cir Cardiovasc 2010; 25(1): 45-50 Rev

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Simple Left Atrial Procedure for Chronic Atrial Fibrillation Associated With Mitral Valve Disease

Cited by 167 publications

References 13 publications

Cardiac fibrillation: From ion channels to rotors in the human heart

Cardiac fibrillation: From ion channels to rotors in the human heart

Long-Term Results after the Box Pulmonary Vein Isolation Procedure for Chronic Atrial Fibrillation in Mitral Valve Surgery

Avaliação inicial da ablação operatória biatrial por radiofrequência de fibrilação atrial

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