[Surgery ablation of atrial fibrillation with epicardial and endocardial biauricular radiofrequency: initial experience].
BACKGROUND
Atrial fibrillation is frequent in surgical patients with cardiac valvulopathies. Radiofrequency energy applied by means of surgical probes permits the reproduction of atriotomies described in the maze surgical procedure for the ablation of atrial fibrillation in a fast, safe and efficient way. This study presents our initial experience in treatment of chronic atrial fibrillation through radiofrequency performed in patients with surgical cardiac valvulopathies.


METHODS
From June to November 2000, 10 patients, with surgical indications of valvulopathy, were intraoperatively treated through radiofrequency for its atrial fibrillation. Ablations were performed in the right auricle from the epicardium before starting extra corporeal circulation, and in the left auricle from the endocardium, while under circulation. Radiofrequency was applied through a surgical multielectrode probe.


RESULTS
Eight patients (80%) presented some type of postoperative arrhythmia, with relapse of paroxysmal fibrillation in 3 patients and flutter in another one. At discharge, none of the patients presented relapse of chronic atrial fibrillation. There was no in-hospital mortality. After a mean follow-up of 3 months (range 1-6), 8 patients (80%) have recovered and maintained sinus rhythm. Only one patient has re-established echocardiographic biatrial contraction.


CONCLUSIONS
Intraoperative radiofrequency has allowed us to perform the auricular lesions, in both auricles, in a simple way, with an initial effectiveness of 80%. Epicardial ablation of the right auricle was simple and safe. Although no patient presented relapse of chronic atrial fibrillation at hospital discharge, postoperative arrhythmias have continued to be the main postsurgical problem.
Hornero Sos
Fernando
F
Servicios de Cirugía Cardíaca. Hospital General Universitario de Valencia. Spain. hornero_fer@gva.es
Montero Argudo
José A
JA
Gil Albarova
Oscar
O
García Fuster
Rafael
R
Atienza Fernández
Felipe
F
Paya Serrano
Rafael
R
Pérez Bosca
José Leandro
JL
Quesada Dorador
Aurelio
A
Cánovas López
Sergio
S
Dalmau Sorli
María José
MJ
Bueno Codoñer
María
M
D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged