Atrial function after epicardial microwave ablation in patients with atrial fibrillation.
OBJECTIVE
To study epicardial microwave ablation of concomitant atrial fibrillation and its effects on heart rhythm and atrial function during follow-up.


METHODS
The study included 20 open-heart surgery patients with concomitant atrial fibrillation. Transthoracic echocardiography with flow and tissue Doppler recordings was performed preoperatively and at 6 months postoperatively. Blood samples were obtained preoperatively and postoperatively for analysis of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and amino terminal precursor of brain natriuretic peptide (NT-proBNP).


RESULTS
Fourteen of 19 patients (74%) were in sinus rhythm with no antiarrhythmic drugs at 12 months. All patients in sinus rhythm had preserved left and right atrial-filling waves through atrioventricular valves during atrial contraction. Tissue velocity echocardiography on patients in sinus rhythm showed preserved atrial wall velocities, atrial strain, and atrial strain rate. Levels of natriuretic peptides tended to decrease in patients with stable sinus rhythm at one year compared to patients in atrial fibrillation.


CONCLUSIONS
Epicardial microwave ablation results in sinus rhythm in a majority of patients and seems to preserve atrial mechanical function.
Department of Cardiothoracic Surgery and Anesthesiology, Orebro University Hospital, Orebro, Sweden. anders.ahlsson@orebroll.se
Anders
A
Ahlsson
Peter
P
Linde
Peter
P
Rask
Anders
A
Englund
D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D016275:Atrial Function; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010496:Pericardium / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor