ISSN 1016-5169 | E-ISSN 1308-4488
Mid-term results of surgical radiofrequency ablation for permanent atrial fibrillation [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2009; 37(5): 321-327

Mid-term results of surgical radiofrequency ablation for permanent atrial fibrillation

İlker Mataracı1, Adil Polat2, Bülent Mert3, Mehmet Aksüt1, Kaan Kırali1
1Department Of Cardiovascular Surgery, Kartal Kosuyolu Heart And Research Hospital
2Department Of Cardiovascular Surgery, Military Hospital, Elazığ, Turkey
3Department Of Cardiovascular Surgery, Methodist Hospital, Sivas, Turkey

Atrial fibrillation (AF) is a common problem in cardiac surgery patients. We evaluated the mid-term results of patients who underwent open heart surgery and radiofrequency ablation (RFA).

The study included 79 patients (53 females, 26 males; mean age 53±11 years; range 32 to 76 years) who underwent concomitant RFA for AF during open heart surgery under cardiopulmonary bypass. The majority of patients were in NYHA class III (n=68, 86.1%) and had (n=67, 84.8%) rheumatic heart disease. The mean preoperative AF duration was 47±41 months. The most frequent procedure involved the mitral valve (64 replacements, 11 reconstructions). A unipolar probe was used in 60 patients (76%) and a bipolar probe in 19 patients (24.1%). The mean follow-up period was 20.8±14.7 months (range 1 to 59 months).

The mean perfusion and cross-clamp times were 102.4±15.7 min (range 48 to 171 min) and 76.1±25.0 min (range 27 to 145 min), respectively. In-hospital mortality occurred in two patients (2.5%) and late mortality occurred in three patients (3.8%). One patient (1.3%) required implantation of a permanent pacemaker. During discharge, 58 patients (73.4%) were in sinus rhythm, of which nine (15.3%) developed recurrent AF within a mean of 5.3±4.4 months (range 2 to 12 months). Transient atrial flutter was seen in three patients (3.8%). Logistic regression analysis showed no risk factor to significantly affect early or late AF recurrence. Six- and 12-month rates of AF-free rhythm were 94.3±3.9% and 87.6±5.9% for operations performed by the year 2006 and 95.2±3.3% and 92.2±4.4% afterwards, respectively (p=0.0001). There was no significant difference with respect to survival between patients discharged with AF and in sinus rhythm (p>0.05).

Radiofrequency ablation is increasingly performed for the treatment of AF, yielding more successful results.

Keywords: Aortic valve/surgery, atrial fibrillation/surgery, cardiopulmonary bypass, catheter ablation/methods; heart valve diseases/surgery.

How to cite this article
İlker Mataracı, Adil Polat, Bülent Mert, Mehmet Aksüt, Kaan Kırali. Mid-term results of surgical radiofrequency ablation for permanent atrial fibrillation. Turk Kardiyol Dern Ars. 2009; 37(5): 321-327

Corresponding Author: İlker Mataracı, Türkiye
Manuscript Language: Turkish

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