title: Analysis of Bipolar Radiofrequency Ablation in Treatment of Atrial Fibrillation Associated with Rheumatic Heart Disease.
abstract: BACKGROUND
  Among patients with rheumatic heart disease (RHD), 45% to 60% present with atrial fibrillation (AF), which is associated with increased rates of thromboembolism, heart failure, and even death. The bipolar radiofrequency ablation (BRFA) combining with mitral valve procedure has been adopted in patients of AF associated with RHD, but evaluations about its effectiveness are still limited.
  
  
  METHODS
  A total of 87 patients with RHD and long persistent AF who had accepted mitral valve replacement concomitant with BRFA were studied. Clinical data were collected to analyze the midterm results of BRFA and evaluate its efficiency. Univariate and multivariate analyses were used to identify the independent factors associated with late AF recurrence.
  
  
  RESULTS
  Sixty-six (75.9%) patients maintained sinus rhythm after a mean follow-up of 13.4 ± 5.2 months. Late AF recurrence had been detected in 21 (24.1%) patients, 11 (12.6%) patients were confirmed to be AF, 8 (9.2%) patients were atrial flutter and 2 (2.3%) patients were junctional rhythm. In Multivariate logistic regression analysis, body mass index (BMI) (OR = 1.756, 95% CI = 1.289-2.391, p = 0.000) and early AF recurrence (OR = 5.479, 95% CI = 1.189-25.254, p = 0.029) were independent predictors of late AF recurrence. In addition, left ventricular ejection fraction (LVEF) and New York Heart Association class showed a greater improvement in patients who maintained sinus rhythm than those who experienced late AF recurrence.
  
  
  CONCLUSIONS
  BRFA is an effective technique for the treatment of long persistent AF associated with RHD during mitral valve replacement. The BMI and early AF recurrence are independent predictors for late AF recurrence. Patients with long-term restoration of sinus rhythm experienced a greater improvement of left ventricular function after BRFA.
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China.
authors.forename: Xiliang
authors.initials: X
authors.lastname: Zhu
authors.affiliation: West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, P. R. China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000628:therapy*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications / Q000628:therapy*