Radiofrequency ablation of atrial fibrillation during mitral valve surgery.
Twenty-three patients underwent endocardial radiofrequency ablation of atrial fibrillation (AF) during mitral valve procedures with a previously described left atrial lesion pattern. A temperature-controlled 7-coil surgical probe delivered 60-second lesions at 80 degrees C. The left atrial appendage was oversewn after ablation. Ages ranged from 28 to 88 years. Nineteen patients had chronic AF that was present for over 1 year in 74%; 12 patients had rheumatic mitral stenosis. Mean left atrial diameter was 5.4 +/- 0.7 cm. There was 1 operative death unrelated to the ablation, and no strokes or ablation-related complications were observed. At mean follow-up of 32.5 weeks, 86% of the 22 survivors were in sinus rhythm. All 18 patients with left atrial diameter <6 cm are in sinus rhythm. All postoperative atrial flutter was transient, and no patients required subsequent transcatheter ablation. This lesion pattern is safe and effective when applied in the method described here. It appears to be a reasonable alternative to the complete Maze 3 lesion pattern in patients with mitral valve disease.
Kress
David C
DC
Department of Cardiothoracic Surgery and Electrophysiology, Aurora Sinai and St. Luke's Medical Centers, Milwaukee, WI, USA.
Sra
Jasbir
J
Krum
David
D
Goel
Anil
A
Campbell
Jennifer
J
Fox
Jeff
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology