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

Abstract

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.

Catheter ablation versus surgical ablation combined with mitral valve surgery for nonparoxysmal atrial fibrillation in patients with moderate mitral regurgitation

“…In our study, the long‐term SR maintenance of SA + MV surgery was significantly higher than that of RFCA, with a survival rate free of ATa recurrence of 63.8% at a median follow‐up of 24 months. A similar outcome was observed in Abdur Rahim’s study, in which SR maintenance rate was 71% for 1 year after surgery . The possible mechanisms are mainly as follows: 1) elimination or mitigation of MR: the presence of moderate MR imposed considerable volume and pressure overload on LA, as was illustrated in the echocardiographic results of the patients enrolled, resulting in local conduction heterogeneities and electrical dissociation between muscle bundles, favoring reentry, and arrhythmia perpetuation .…”

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam

“…Despite these authors performing open surgery, our results demonstrate that good outcomes can be achieved even with minimally invasive surgery. [14][15][16] In numerous studies, the use of Cordarone (amiodarone) for 3 months following surgical ablation of AF has shown a significant reduction in AF recurrence. 17,18 In our practice, patients were prescribed Cordarone for up to 3 months after surgery, with discontinuation occurring in case of drugrelated complications or after the 3-month period.…”