title: Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring.
abstract: Continuous monitoring of cardiac rhythm may play an important role in measuring the true symptomatic/asymptomatic atrial fibrillation (AF) burden and improve the management of anti-arrhythmic and anti-thrombotic therapies. Forty-seven patients with mitral valve disease and longstanding persistent AF (LSPAF) underwent a left atrial maze procedure with bipolar radiofrequency and valve surgery. The follow-up data recorded by an implanted loop recorder were analysed after 3, 6 and 12 months. On discharge, 40 (85.1%) patients were in stable sinus rhythm, as documented by in-office electrocardiography (ECG), 4 (8.5%) were in pacemaker rhythm and 3 (6.4%) were in AF. One (2.1%) patient died after 7 months. On 12-month follow-up examination, 30 (65.2%) patients had an AF burden <0.5% and were classified as responders. Three (6.5%) of the 16 non-responders had atrial flutter and 13 (27.7%) had documented AF recurrences with an AF burden >0.5%. Two (4.3%) patients with AF recurrences were completely asymptomatic. Among the symptomatic events stored by the patients, only 27.6% was confirmed as genuine AF recurrences according to the concomitant ECG recorded by the implanted loop recorder. A concomitant bipolar maze procedure during mitral valve surgery is effective in treating AF, as proved by detailed 1-year continuous monitoring.
authors.affiliation: Department of Heart Valves Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation. b-pav@rambler.ru
authors.forename: Alexandr
authors.initials: A
authors.lastname: Bogachev-Prokophiev
authors.forename: Sergey
authors.initials: S
authors.lastname: Zheleznev
authors.forename: Alexander
authors.initials: A
authors.lastname: Romanov
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pokushalov
authors.forename: Alexey
authors.initials: A
authors.lastname: Pivkin
authors.forename: Giorgio
authors.initials: G
authors.lastname: Corbucci
authors.forename: Alexander
authors.initials: A
authors.lastname: Karaskov
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D001282:Atrial Flutter / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D015716:Electrocardiography, Ambulatory; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012426:Russia; D013997:Time Factors; D016896:Treatment Outcome