Intraoperative radiofrequency ablation to treat permanent atrial fibrillation during concomitant car

来源 :第八届北京五洲国际心血管病会议 | 被引量 : 0次 | 上传用户:babaxsj
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  Objective To summarize the clinical outcomes of modified maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of permanent atrial fibrillation (AF) and heart valve diseases.And evaluate its safety and efficacy.Methods A total of 70 patients with permanent AF and heart valves diseases were undergone surgical treatment from April 2010 to Novemberl 2013 in the Second Affiliated Hospital of Anhui Medical University, 42 males and 28 females with age 38 to 76 (49.8 ± 10.7) years old.Rheumatic heart disease was in 65 cases and 5 cases of them had suffered degenerative disease of the heart valves.The Medtronic Cardioblate 68000 flush bipolar radiofrequency ablation system applied to all patients.Ring RF ablation procedures was consisted of bilateral pulmonary vein isolation, left atrial appendage resection, left and fight atrial ablation (modified Cox-maze Ⅲ surgical path) and Marshall ligament resection.All patients taking amiodarone therapy after surgery for 3-6 month.Results The surgery of 70 patients was successfully completed.The mean atrial fibrillation duration was (13.9±6.1) rmin.All patients takedamiodarone hydrochloride after surgery.The day after surgery, 62 cases atrial fibrillation rhythm turned into sinus rhythm.paroxysmal atrial fibrillation occurred in 6 cases after two weeks after surgery, and 5 cases turned into sinus rhythm after intravenous amiodarone.In all patients, 2 of them had suffered Ⅲ°atrioventrieular block after surgery and permanent pacemakers were applicated.There were no cardiac perforation and non-hospital mortality.The average length of stay was (12.3±2.1) d.The mean follow-up was (8.5±5.0) m.82.86% (58/70) of patients remained in sinus rhythm, 14.28% (10/70) in AF rhythm, 2.86% (2/70) in paced rhythm after 6 months of the operation.Conclusion Modifiedmaze procedure using bipolar radio frequency ablation is a simple, safe and effective surgical procedure for the treatment of permanent atrial fibrillation.and worthy of clinical promotion.
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