| Abstract | AIMS: To demonstrate the safety and efficacy of saline irrigated cooled-tip atrial linear endocardial radiofrequency ablation (SICTRA) concomitant to open-heart surgical procedures in the treatment of permanent atrial fibrillation (AF). METHODS AND RESULTS: Two hundred and twenty-two patients presenting with permanent AF and the need for cardiac surgery were included. In addition to the cardio-surgical procedure [mitral valve (MV) surgery (n = 94), aortic valve replacement (n = 29), bypass surgery (n = 76 including 24 patients with additional MV surgery), and combined procedures (n = 23)] concomitant SICTRA was performed. In 116 patients, the ablation pattern was restricted to the left atrium alone. During the mean follow-up of 29 months, 174 patients (78%) converted to sinusrhythm (SR). In patients with SICTRA restricted to the left atrium conversion rates were not different compared to a biatrial approach (83 vs. 74%, P = 0.47). Thirty-days mortality was found to be 4% (9/222). Post-mortem evaluation revealed 23% of all lesions to be histologically non-transmural. In the overall group, only 4% of patients developed sustained secondary regular atrial arrhythmia. CONCLUSIONS: SICTRA safely and effectively restores stable SR in 78% of patients with permanent AF undergoing open-heart surgery. Rhythm outcome is not influenced by treatment of the right atrium. Sustained regular atrial arrhythmia with the need for invasive treatment strategies occurs in 4% although intra-operative ablation lesions are often non-transmural. |
| Authors | Thomas Deneke, Krishna Khargi, Bernd Lemke, Thomas Lawo, Michael Lindstaedt, Alfried Germing, Turgut Brodherr, Leif Bösche, Andreas Mügge, Axel Laczkovics, Peter H Grewe, Markus Fritz
(Affiliation: University Heart Center Bochum, BG University-Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. thomas.deneke at rub.de)
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| Journal | European heart journal
(Eur Heart J)
Vol. 28
Issue 23
Pg. 2909-14
(Dec 2007)
ISSN: 0195-668X England |
| PMID | 17956873
(Publication Type: Evaluation Studies, Journal Article)
|
| Topics |
- Adult
- Aged
- Aged, 80 and over
- Aortic Valve
(transplantation)
- Atrial Fibrillation
(mortality, surgery)
- Catheter Ablation
(instrumentation, methods)
- Combined Modality Therapy
(methods)
- Coronary Artery Bypass
(methods)
- Follow-Up Studies
- Humans
- Intraoperative Period
- Middle Aged
- Mitral Valve
(surgery)
|
