Long-term follow-up after endocardial radiofrequency modified Nitta procedure for concomitant atrial fibrillation treatment.
In atrial fibrillation (AF) patients, the surgical restoration of sinus rhythm aims at restoring atrial contraction, hence to decrease thromboembolic events. We investigated the long-term outcome of radiofrequency (RF) ablation by a modified Nitta procedure, in patients with AF associated with operative structural heart diseases. Between September 2000 and April 2004, a total of 20 patients (63.7+/-13.34 years) with structural heart diseases due to surgery and chronic AF underwent endocardial RF ablation. Evaluation was achieved at discharge, at 6 months, 12 months and in November 2005. Echocardiography, 12-derivations electrocardiogram and 24-h electrocardiogram were obtained. At the mean follow-up of 43.25+/-13.4 months, 14 out of 20 patients (70%) were in sinus rhythm. Actuarial freedom from AF recurrence was 85% after 6 months, 75% after 12 months and 70% at the follow-up completion. Effective atrial contraction was present in 78.5% of patients with sinus rhythm. No hemodynamic pulmonary edema has been reported during the hospital stay, and no thromboembolic event has been reported during the follow-up period. The Nitta procedure, modified for RF ablation, is an easy procedure when performed in the setting of structural heart disease surgery. Further studies are warranted to evaluate this technique on a larger scale basis.
Department of Cardiac Surgery, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium. beloumei@ulb.ac.be
Bachar
B
El Oumeiri
Costantin
C
Stefanidis
Ahmed
A
Sabry
Martine
M
Antoine
Jean-Marie
JM
De Smet
Didier
D
De Cannière
Jean-Luc
JL
Jansens
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015996:Survival Rate; D016896:Treatment Outcome