Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation

OBJECTIVE: Permanent atrial fibrillation (pAF) is a serious problem in cardiac surgery: An incidence of 3.5% among all patients scheduled for open heart surgery, 9.8% in heart valve cases and 45.6% among patients with severe rheumatic mitral valve (MV) disease was observed in our institution. Our ex...

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Autores principales: Geidel, Stephan, Ostermeyer, Jorg, Lass, Michael, Boczor, Sigrid, Kuck, Karl-Heinz
Formato: Texto
Lenguaje:English
Publicado: Indian Pacing and Electrophysiology Group 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502041/
https://www.ncbi.nlm.nih.gov/pubmed/16943907
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author Geidel, Stephan
Ostermeyer, Jorg
Lass, Michael
Boczor, Sigrid
Kuck, Karl-Heinz
author_facet Geidel, Stephan
Ostermeyer, Jorg
Lass, Michael
Boczor, Sigrid
Kuck, Karl-Heinz
author_sort Geidel, Stephan
collection PubMed
description OBJECTIVE: Permanent atrial fibrillation (pAF) is a serious problem in cardiac surgery: An incidence of 3.5% among all patients scheduled for open heart surgery, 9.8% in heart valve cases and 45.6% among patients with severe rheumatic mitral valve (MV) disease was observed in our institution. Our experience with radiofrequency (RF) ablation procedures to treat pAF in these cases is reported. METHODS: Since February 2001 monopolar endocardial RF ablation procedures creating two encircling isolation lesions around the left and the right pulmonary veins (LPVs, RPVs) and a connection line between both were performed in patients with pAF concomitant to heart valve surgery. Since March 2003 bipolar RF ablation was used as an adjunct to CABG surgery. Amiodarone was given for 3 months after surgery. RESULTS: Sixtytwo patients with pAF underwent surgical ablation procedures and primary valve (mitral: n=45; aortic: n=13; aortic+mitral: n=1; LA-diameter 55.6±7.3 mm) or CABG surgery (n=3). Follow-up was performed at 3, 6, 9, 12, 18 and 24 months; 75% had stable sinus rhythm (SR) at late follow-up. Almost 90% of the patients with a preoperative LA-diameter of <56mm had SR. CONCLUSION: Isolation of the PVs using RF ablation procedures in combination with amiodarone therapy represents a safe and efficient option to cure pAF in patients undergoing open heart surgery.
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spelling pubmed-15020412006-08-29 Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation Geidel, Stephan Ostermeyer, Jorg Lass, Michael Boczor, Sigrid Kuck, Karl-Heinz Indian Pacing Electrophysiol J Original Article OBJECTIVE: Permanent atrial fibrillation (pAF) is a serious problem in cardiac surgery: An incidence of 3.5% among all patients scheduled for open heart surgery, 9.8% in heart valve cases and 45.6% among patients with severe rheumatic mitral valve (MV) disease was observed in our institution. Our experience with radiofrequency (RF) ablation procedures to treat pAF in these cases is reported. METHODS: Since February 2001 monopolar endocardial RF ablation procedures creating two encircling isolation lesions around the left and the right pulmonary veins (LPVs, RPVs) and a connection line between both were performed in patients with pAF concomitant to heart valve surgery. Since March 2003 bipolar RF ablation was used as an adjunct to CABG surgery. Amiodarone was given for 3 months after surgery. RESULTS: Sixtytwo patients with pAF underwent surgical ablation procedures and primary valve (mitral: n=45; aortic: n=13; aortic+mitral: n=1; LA-diameter 55.6±7.3 mm) or CABG surgery (n=3). Follow-up was performed at 3, 6, 9, 12, 18 and 24 months; 75% had stable sinus rhythm (SR) at late follow-up. Almost 90% of the patients with a preoperative LA-diameter of <56mm had SR. CONCLUSION: Isolation of the PVs using RF ablation procedures in combination with amiodarone therapy represents a safe and efficient option to cure pAF in patients undergoing open heart surgery. Indian Pacing and Electrophysiology Group 2003-07-01 /pmc/articles/PMC1502041/ /pubmed/16943907 Text en Copyright: © 2003 Geidel et al. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Geidel, Stephan
Ostermeyer, Jorg
Lass, Michael
Boczor, Sigrid
Kuck, Karl-Heinz
Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title_full Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title_fullStr Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title_full_unstemmed Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title_short Surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
title_sort surgical treatment of permanent atrial fibrillation during cardiac surgery using monopolar and bipolar radiofrequency ablation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502041/
https://www.ncbi.nlm.nih.gov/pubmed/16943907
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