Combined atrial fibrillation and mitral valve surgery using radiofrequency technology.
Recently, intraoperative radiofrequency ablation of the left atrium combined with mitral valve surgery has become widely used. In our center, 30 patients underwent this combined procedure; median sternotomy was used in 16 patients, and port access was used in 14 patients. At hospital discharge, 18 patients (60%) were no longer in atrial fibrillation, and at 6 months, 19 patients (65%) remained in sinus rhythm. All sinus rhythm patients had a well-defined transmitral A wave detectable by echocardiography. One patient sustained a major stroke. Two patients required pacemaker implantation. Such encouraging preliminary results have triggered worldwide interest in the percutaneous and surgical treatment of atrial fibrillation. However, the excellent long-term results with the classic Cox-Maze III operation have not yet been achieved with these newer approaches. Further basic and clinical research is required before a predictable simple and safe technique can be introduced as a new standard for the surgical treatment of atrial fibrillation in patients with or without structural heart disease.
Wellens
Francis
F
Department of Thoracic and Cardiovascular Surgery, Onze-Lieve-Vrouw Clinic, Aalst, Belgium.
Casselman
Filip
F
Geelen
Peter
P
Brugada
Pedro
P
Van Praet
Frank
F
De Geest
Raphael
R
Degrieck
Ivan
I
Vanermen
Hugo
H
D001281:Atrial Fibrillation / Q000150:complications* / Q000601:surgery*; D001530:Belgium; D017115:Catheter Ablation / Q000295:instrumentation; D002908:Chronic Disease; D003131:Combined Modality Therapy; D017548:Echocardiography, Transesophageal; D015716:Electrocardiography, Ambulatory; D006349:Heart Valve Diseases / Q000150:complications* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome