Tratamiento quirúrgico curativo de la fibrilación atrial mediante técnica de ablación con radiofrecuencia monopolar irrigada: resultados a corto y mediano plazo / Surgical treatment of atrial fibrillation through irrigated ablation with monopolar radiofrequency: results to short and midterm

RESUMEN

No existe una publicación colombiana con seguimiento a mediano plazo acerca del uso de esta técnica.Objetivo: evaluar el tratamiento quirúrgico de la fibrilación auricular a través de radiofrecuencia monopolar irrigada, mediante el seguimiento clínico, electrocardiográfico y ecocardiográfico a corto y mediano plazo. Métodos: entre septiembre de 2003 y octubre de 2005, se evaluaron de manera prospectiva, 70 pacientes con diagnóstico de fibrilación atrial y otra patología cardiaca que requería intervención quirúrgica. Se utilizó el sistema de ablación por radiofrecuencia monopolar Cardioblate (marca registrada) (Medtronic, Inc.). Los resultados se analizaron en un paquete estadístico SPSS versión 1...

ABSTRACT

There is not any publication about the use of this technique with midterm follow-up in Colombia.bjective to evaluate the surgical treatment of atrial fibrillation with the use of irrigated monopolar radiofrequency to short and midterm, through clinical follow-up, electrocardiogram and echocardiogram.Methods: 70 patients with diagnosis of atrial fibrillation and some other heart pathology that required surgery were evaluated between September 2003 and October 2005, in a prospective way. An ablation though monopolar radiofrequency (Cardioblate® Medtronic, Inc) was performed. Results were analyzed with the SPSS version 11, 0 statistical package. Results: 70 patients, 52% females and 48% males with mean age 54 years and preoperatory ejection fraction of 47% had mitral insufficiency (49%) and mitral stenosis (26%) as their main cause for primary heart surgery. 87% patients were evaluated at 18 months (3 to 25 months). Sinus rhythm was achieved in 88%. Residual arrhythmias in this group were atrial fibrillation (6%) and atrial flutter (6%). 80% of post-operatory arrhythmias were found in the first 15 days after surgery, being atrial fibrillation and atrial flutter the most common ones. Anticoagulation and anti-arrhythmic medication was suspended in 89% and 90% of the patients, respectively. The surgical technique had no inherent complications. Conclusions: this investigation demonstrated that the surgical ablation of atrial fibrillation with irrigated monopolar radiofrequency is easily reproducible, highly effective and safe for the patient.