[Concomitant treatment of atrial fibrillation in open-heart surgery patients: late rhythm and functional results].
BACKGROUND
In recent years left atrial approaches have become popular because of technical simplicity, reproducibility and minor surgical trauma compared to the standard maze procedure. We analysed mid-term results of intraoperative left radiofrequency ablation of atrial fibrillation.


METHODS
From February 1998 to August 2002, 206 patients (mean age 59.1 +/- 10.2 years) scheduled for open-heart surgery underwent combined treatment of atrial fibrillation at our Institution. In 163 patients (79.1%) a standard left epicardial approach was performed while 43 patients (20.9%) needed a totally endocardial approach.


RESULTS
All patients but 3 underwent mitral valve surgery (104 repair and 99 replacement). Hospital mortality was 1.9%. Actuarial freedom from atrial fibrillation was 78% at 2 years and 74% at 4 years. At 4 years survival was 94% and freedom from neurological events was 98%. All patients with stable sinus rhythm 3 months after surgery recovered biatrial contractility.


CONCLUSIONS
Left radiofrequency ablation of atrial fibrillation is effective in restoring sinus rhythm and normal atrial function. Combined atrial fibrillation treatment should be considered in all patients undergoing open-heart surgery.
Nascimbene
Simona
S
Divisione di Cardiochirurgia, IRCCS Ospedale San Raffaele, Milano. simona.nascimbene@hsr.it
Benussi
Stefano
S
Calvi
Simone
S
Agricola
Eustachio
E
La Canna
Giovanni
G
Pappone
Carlo
C
Alfieri
Ottavio
O
D000206:Actuarial Analysis; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000601:surgery*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D009200:Myocardial Contraction; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000601:surgery; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000601:surgery