Comparison of uniatrial and biatrial radiofrequency ablation procedures in atrial fibrillation: initial results.

BACKGROUND: Atrial fibrillation (AF) is the most commonly sustained cardiac rhythm disturbance. Surgical ablation techniques were developed involving the left atrium only and modifications of the maze procedure in ablating both atria. OBJECTIVE: The aim of this study was to compare, in patients with permanent AF, the efficacy of uniatrial versus biatrial radiofrequency ablation procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHOD: Between September 2003 and May 2009, 30 patients were submitted to the radiofrequency ablation procedure for AF associated with concomitant cardiac surgery; 15 patients underwent a uniatrial procedure, and 15 patients underwent biatrial ablation. The mean age was 47.73 ± 9.85 years, and 53.4% were men. The average followup time was 12.16 ± 10.89 months for the uniatrial group and 7.0 ± 4.0 months for the biatrial group. RESULTS: Neither hospital mortality nor complications related to radiofrequency ablation were was registered. At the time of hospital discharge, 9 patients (60%) were in a state of sinus rhythm in both groups. However, patients undergoing biatrial ablation (range 73.3% versus 46.7%) demonstrated complete freedom from atrial fibrillation at all times. CONCLUSION: Biatrial ablation surgical procedures were more effective in controlling atrial fibrillation than procedures limited to the left atrium.

Surgical biatrial ablation of atrial fibrillation: initial results.

OBJECTIVE: To evaluate the results of intraoperative radiofrequency ablation with biatrial procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHODS: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 +/- 9.85 years and 60% were male. The mean left atrial diameter was 55.06 +/- 7.56 mm. RESULTS: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 +/- 4 months. At the time of hospital discharge nine (60%) patients were in sinus rhythm. After a mean follow-up period 11 (73.3%) were in sinus rhythm. CONCLUSION: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm.

Avaliação inicial da ablação operatória biatrial por radiofrequência de fibrilação atrial / Surgical biatrial ablation of atrial fibrillation: initial results

OBJETIVO: Apresentar o resultado inicial da ablação operatória de fibrilação atrial (FA) por radiofrequência irrigada, aplicada em ambos os átrios, para reversão e manutenção do ritmo sinusal, a curto e médio prazo, nos pacientes submetidos à operação cardíaca concomitante da valva mitral. MÉTODOS: Entre fevereiro de 2008 e maio de 2009, 15 pacientes consecutivos portadores de FA permanente foram submetidos à ablação intraoperatória da taquiarritmia por radiofrequência irrigada, aplicada de forma biatrial, com operação cardíaca concomitante (plastia ou troca valvar mitral). O grupo era constituído de nove (60 por cento) pacientes do sexo masculino, com idades variando de 25 a 59 anos (média de 47,73 ± 9,85 anos). O diâmetro do átrio esquerdo variou de 44 a 70 mm (média de 55,06 ± 7,56 mm). RESULTADOS: Não houve mortalidade hospitalar ou complicações relacionadas à radiofrequência. Na alta hospitalar, 9 (60 por cento) pacientes estavam em ritmo sinusal. No tempo médio de seguimento de 7 ± 4 meses, 11 (73,3 por cento) pacientes estavam em ritmo sinusal. CONCLUSÕES: A ablação operatória por radiofrequência irrigada da fibrilação atrial crônica, aplicada em ambos os átrios, é efetiva na reversão e manutenção do ritmo sinusal, no seguimento a curto e médio prazo. A inclusão de maior número de pacientes e a continuidade do seguimento pós-operatório são necessárias para confirmar a efetividade da técnica empregada.

OBJECTIVE: To evaluate the results of intraoperative radiofrequency ablation with biatrial procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHODS: Between February 2008 and May 2009, 15 consecutive patients were underwent mitral valve procedure plus modified radiofrequency biatrial ablation of chronic atrial fibrillation. The mean age was 47.73 ± 9.85 years and 60 percent were male. The mean left atrial diameter was 55.06 ± 7.56 mm. RESULTS: There were no hospital mortality or complications related to radiofrequency ablation. The mean follow-up period was 7 ± 4 months. At the time of hospital discharge nine (60 percent) patients were in sinus rhythm. After a mean follow-up period 11 (73.3 percent) were in sinus rhythm. CONCLUSION: Intraoperative biatrial radiofrequency ablation is a safe and effective technique for the treatment of chronic atrial fibrillation, with satisfactory midterms outcomes in terms of conversion to sinus rhythm.