title: Left atrial radiofrequency ablation during cardiac surgery in patients with atrial fibrillation.
abstract: BACKGROUND
  Intraoperative left atrial radiofrequency (RF) ablation recently has been suggested as an effective surgical treatment for atrial fibrillation (AF). The aim of this study was to verify the outcome of this technique in a controlled multicenter trial.
  
  
  RESULTS
  One hundred three consecutive patients (39 men and 65 women; age 62 +/- 11 years) affected by AF underwent cardiac surgery and RF ablation in the left atrium (RF group). The control group consisted of 27 patients (6 men and 21 women; age 64 +/- 7 years) with AF who underwent cardiac surgery during the same period and refused RF ablation. Mitral valve disease was present in 89 (86%) and 25 (92%) patients, respectively (P = NS). RF endocardial ablation was performed in order to obtain isolation of both right and left pulmonary veins, a lesion connecting the previous lines, and a lesion connecting the line encircling the left veins to the mitral annulus. Upon discharge from the hospital, sinus rhythm was present in 65 patients (63%) versus 5 patients (18%) in the control group (P < 0.0001). Mean time of cardiopulmonary bypass was longer in the RF group (148 +/- 50 min vs 117 +/- 30 min, P = 0.013). The complication rate was similar in both groups, but RF ablation-related complications occurred in 4 RF group patients (3.9%). After a mean follow-up of 12.5 +/- 5 months (range 4-24), 83 (81%) of 102 RF group patients were in stable sinus rhythm versus 3 (11%) of 27 in the control group (P < 0.0001). The success rate was similar among the four surgical centers. Atrial contraction was present in 66 (79.5%) of 83 patients in the RF group in sinus rhythm.
  
  
  CONCLUSIONS
  Endocardial RF left atrial compartmentalization during cardiac surgery is effective in restoring sinus rhythm in many patients. This technique is easy to perform and reproducible. Rare RF ablation-related complications can occur. During follow-up, sinus rhythm persistence is good, and biatrial contraction is preserved in most patients.
authors.affiliation: Cardiovascular Department, Ospedale Regionale Santa Maria dei Battuti di Treviso, Italy. r.mantoban@serenacom.net
authors.forename: Roberto
authors.initials: R
authors.lastname: Mantovan
authors.forename: Antonio
authors.initials: A
authors.lastname: Raviele
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Buja
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bertaglia
authors.forename: Francesco
authors.initials: F
authors.lastname: Cesari
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedrocco
authors.forename: Cluadio
authors.initials: C
authors.lastname: Zussa
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Carlo
authors.initials: C
authors.lastname: Valfrè
authors.forename: Paolo
authors.initials: P
authors.lastname: Stritoni
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies