Therapeutic effect of Atricure bipolar radiofrequency ablation on patients with rheumatic heart disease complicated atrial fibrillation／ / 心血管康复医学杂志

ABSTRACT

Objective:To explore therapeutic effect of Atricure bipolar radiofrequency ablation on patients with rheu‐matic heart disease (RHD) complicated atrial fibrillation (AF) and its safety .Methods:A total of 90 RHD+AF pa‐tients ,who were treated in our hospital from Apr 2015 to Apr 2016 ,were selected .All patients received valve re‐placement ;according to radiofrequency ablation (RFA) mode ,patients were divided into bipolar RFA group (n＝45 ,received Atricure bipolar RFA ) and unipolar RFA group (n＝45).Aortic occlusion time during surgery ,bypass time ,incidence of surgery‐related complications ,AF conversion rates and changes of cardiac function after surgery were observed and compared between two groups .Results:Compared with unipolar RFA group ,there were signifi‐cant reductions in aortic occlusion time [ (78.12 ± 23.42) min vs.(65.03 ± 21.37) min] and bypass time [ (164. 59 ± 50. 74) min vs.(115. 37 ± 36.45) min] in bipolar RFA group ( P＝0.007 ,0.001).No surgery‐related complica‐tion occurred in bipolar RFA group ,while there were four cases who needed permanent pacemaker implantation in unipolar RFA group .AF conversion rate on one ,three and six months after surgery in bipolar RFA group were sig‐nificantly higher than those of unipolar RFA group (86. 67% vs.68. 89%, 91. 11% vs.71.11%, 93. 33% vs 77. 78%) , P＜0.05 all.Compared with unipolar RFA group on six months after surgery ,there was significant rise in LVEF [ (53.29 ± 6.91)% vs.(56. 47 ± 7. 84)%] in bipolar RFA group ( P＝0.044).Compared with unipolar RFA group on one year after surgery ,there were significant rise in AF conversion rate (71.11% vs.88. 89%) and LVEF [ (54. 27 ± 6. 32)% vs.(59.03 ± 7.02)%] , P＝0.035 , 0. 001 ,and significant reduction in LVEDd [ (51. 38 ± 9.16) mm vs.(47. 42 ± 8.31) mm] in bipolar RFA group ( P＝0.034) . Conclusion:Atricure bipolar radiofre‐quency ablation possesses significant short‐term therapeutic effect and higher safety in patients with rheumatic heart disease complicated atrial fibrillation .