Surgical Ablation of Atrial Fibrillation Using Energy Sources

Brick, Alexandre Visconti; Braile, Domingo Marcolino

doi:10.5935/1678-9741.20150078

Cited by 7 publications

(14 citation statements)

References 62 publications

(74 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This result is consistent with the literature [12] . Meta-analysis of results of 62 studies on surgical ablation in patients with AF undergoing mitral valve surgery show a significantly higher rate of sinus rhythm in these patients, with no increase in mortality rate [16] .…”

Section: Discussionsupporting

confidence: 94%

“…In a recent literature review, Brick & Braile [12] identified 72 studies on evolution and improvement of surgery of arrhythmias. Analyzing studies with immediate results, the percentage of return to sinus rhythm ranged from 73% to 96%, while those of long-term results (12 months on) ranged from 62% to 97.7%.…”

Section: Discussionmentioning

confidence: 99%

“…The use of catheter ablation for the treatment of supraventricular arrhythmias stimulated the use of energy sources to cause linear ablative lesions, with either endocardial or epicardial application or both, replacing the section and suture of the atrial wall [11,12] . 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%

See 2 more Smart Citations

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Brick

Braile

2017

Braz J Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Brick

Braile

2017

Braz J Cardiovasc Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…There has been a demand for less invasive procedures, such as manipulation only in the pulmonary veins and intraoperative ablation of atrial walls with alternative energy sources (cryoablation, microwave, RF, laser, and ultrasound), and thoracoscopy procedures using RF and ultrasound catheters from the epicardium in on-pump surgeries [6] . With ensuring SR and effective atrial contraction, myocardial remodeling and heart failure due to tachycardia are prevented [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Jessurun et al [13] found sinus, paroxysmal AF and chronic AF rhythms preoperatively in 162 patients, 71% of patients with SR, 34% of patients with paroxysmal AF, and 4% of patients with chronic AF were in SR. Brick & Braile [6] analyzing studies with immediate results (n=5), the percentage of return to SR ranged from 73% to 96%, while those with long-term results (n=20) (from 12 months on) ranged from 62% to 97.7%. Even with postoperative antiarrhythmic drug treatment and electrical cardioversion, returning to SR was found below 25% in the long-term follow-up [14] .…”

Section: Discussionmentioning

confidence: 99%

The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

Çolak¹,

Kaya²,

Ceviz³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

View full text Add to dashboard Cite

ObjetiveSaline-irrigated radiofrequency ablation, which has been widely used for surgical treatment of atrial fibrillation in recent years, is 80-90% successful in achieving sinus rhythm. In our study, our surgical experience and mid-term results in patients who underwent mitral valve surgery and left atrial radiofrequency ablation were analyzed.MethodsForty patients (15 males, 25 females; mean age 52.05±9.9 years; range 32-74) underwent surgery for atrial fibrillation associated with mitral valvular disease. All patients manifested atrial fibrillation, which started at least six months before the surgical intervention. The majority of patients (36 patients, 90%) were in NYHA class III; 34 (85%) patients had rheumatic heart disease. In addition to mitral valve surgery and radiofrequency ablation, coronary artery bypass, DeVega tricuspid annuloplasty, left ventricular aneurysm repair, and left atrial thrombus excision were performed. Following discharge from the hospital, patients' follow-up was performed as outpatient clinic examinations and the average follow-up period of patients was 18±3 months.ResultsWhile the incidence of sinus rhythm was 85.3% on the first postoperative day, it was 80% during discharge and 71% in the 1st year follow-up examination.ConclusionRadiofrequency ablation is an effective method when it is performed by appropriate surgical technique. Its rate for returning to sinus rhythm is as high as the rate of conventional surgical procedure.

show abstract

Surgical Treatment of Atrial Fibrillation in Patients with Rheumatic Valve Disease

Chavez¹,

Colafranceschi²,

Monteiro³

et al. 2017

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

ObjectiveTo assess heart rhythm and predictive factors associated with sinus rhythm after one year in patients with rheumatic valve disease undergoing concomitant surgical treatment of atrial fibrillation. Operative mortality, survival and occurrence of stroke after one year were also evaluated.MethodsRetrospective longitudinal observational study of 103 patients undergoing rheumatic mitral valve surgery and ablation of atrial fibrillation using uni- or bipolar radiofrequency between January 2013 and December 2014. Age, gender, functional class (NYHA), type of atrial fibrillation, EuroSCORE, duration of atrial fibrillation, stroke, left atrial size, left ventricular ejection fraction, cardiopulmonary bypass time, myocardial ischemia time and type of radiofrequency were investigated.ResultsAfter one year, 66.3% of patients were in sinus rhythm. Sinus rhythm at hospital discharge, lower left atrial size in the preoperative period and bipolar radiofrequency were associated with a greater chance of sinus rhythm after one year. Operative mortality was 7.7%. Survival rate after one year was 92.3% and occurrence of stroke was 1%.ConclusionAtrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year. Discharge from hospital in sinus rhythm was a predictor of maintenance of this rhythm. Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm. Operative mortality rate of 7.7% and survival and stroke-free survival contribute to excellent care results for this approach.

show abstract

Surgical Ablation of Atrial Fibrillation Using Energy Sources

Cited by 7 publications

References 62 publications

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

Chronic Atrial Fibrillation Ablation with Harmonic Scalpel during Mitral Valve Surgery

The Mid-Term Results of Patients who Underwent Radiofrequency Atrial Fibrillation Ablation Together with Mitral Valve Surgery

Surgical Treatment of Atrial Fibrillation in Patients with Rheumatic Valve Disease

Contact Info

Product

Resources

About