[Open heart radio frequency left atrial compartmentation during mitral valve surgery: an alternative to the labyrinth procedure?].
The authors report their experience of radiofrequency left atrial compartimentation during open heart mitral valve surgery on 37 patients with a 42 +/- 12 months history of atrial fibrillation. The preoperative left ventricular ejection fraction was 62 +/- 8%; the left atrial diameter was 59 +/- 11 mm. The mean operative time was 245 +/- 60 minutes, which included 19 +/- 5 minutes for the ablation procedure. There were 2 early postoperative deaths and 2 deaths from non-cardiac causes at 3 and 6 months. The left ventricular ejection fraction and left atrial dimension were significantly decreased at the time of hospital discharge (54 +/- 12% and 51 +/- 7 mm respectively) (p < 0.01). After an average follow-up of 1 year, 81% of patients were free of atrial fibrillation: 6 patients had undergone DC cardioversion and 1 had a dual-chamber pacemaker. Patients in sinus rhythm after the ablation were associated with shorter periods of atrial fibrillation and smaller left atrial dimensions postoperatively than those who remained in fibrillation. The authors conclude that radiofrequency compartimentation of the left atrium associated with antiarrhythmic therapy can interrupt atrial fibrillation in 81% of patients at 1 year: the ablation procedure takes only 8% of the operation time. Predictive factors of success of ablation should be defined to determine which patients benefit most from this technique.
Schläpfer
J
J
Division de cardiologie et service de chirurgie cardiovasculaire, centre hospitalier universitaire vaudois, 1011 Lausanne, Suisse. Jurg.Schlaepfer@chuv.hospvd.ch
Ruchat
P
P
Delabays
A
A
Hurni
M
M
Milne
J
J
von Segesser
L K
LK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology; D016279:Atrial Function, Left / Q000502:physiology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000145:classification; D011846:Radio Waves; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*
Compartimentation auriculaire gauche par radiofréquence à ciel ouvert lors de chirurgie mitrale: une alternative possible à l'opération du labyrinthe?