[The clinical study of circumferential ablation around orifice of pulmonary vein by radiofrequency energy with chronic atrial fibrillation undergoing rheumatic valvular heart surgery].
OBJECTIVE
To evaluate the clinical efficiency of circumferential ablation around orifice of pulmonary vein by radiofrequency (RF) energy in the cure of chronic atrial fibrillation (AF) in patients with rheumatic valvular disease.


METHODS
Radiofrequency catheter ablation was performed in 20 patients with rheumatic valvular disease and chronic AF who underwent heart valve surgery. The ablation temperature was 50 - 60 degrees C and the linear RF ablations were performed encircling the four openings of pulmonary veins and connecting the posterior mitral annulus with the probe made by ourselves especially for this ablative procedure. And amiodarone was given from the third day before the surgery and lasted for 3 months thereafter. Twenty patients with chronic AF who underwent valvular surgery but refused RF ablation were considered as the control group.


RESULTS
Sinus rhythm (SR) restored in 19 patients either spontaneously or after intraoperative direct current cardioversion, immediately after the operation, as compared with 16 patients in the control group. During the follow-up (24 +/- 3) months, 16 of 20 patients (80%) remained in sinus rhythm in patients received ablation, but in control group, SR was presented in only 7 of 20 patients (35%).


CONCLUSIONS
Circumferential ablation around orifice of pulmonary vein by RF energy is safe and effective in restoration and maintenance of SR in patients with rheumatic valvular disease and chronic AF.
Bai
Ben-jian
BJ
Department of Qingdao Starr International Heart (Center) Hospital of Hiser Medical Center, Qingdao 266071, China. drbai@163.com
Zhong
Zhi-huan
ZH
Xin
Ling-peng
LP
Wang
Chun-gui
CG
Wang
Jun-zhi
JZ
Du
Ri-ying
RY
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000209:etiology / Q000628:therapy*; D017115:Catheter Ablation; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications*
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone