[Predictors of Efficacy of Radiofrequency Ablation of Pulmonary Veins Performed During Coronary Bypass Surgery in Patients With Ischemic Heart Disease and Paroxysmal Atrial Fibrillation]
| Autor: | A F Rakhmatullov, Iskenderov Bg |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Radiofrequency ablation medicine.medical_treatment Myocardial Ischemia Catheter ablation law.invention Intraoperative Period law Heart Conduction System Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm Coronary Artery Bypass Tachycardia Paroxysmal Aged business.industry Atrial fibrillation Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Bypass surgery Pulmonary Veins Cardiology Catheter Ablation Female Electrical conduction system of the heart medicine.symptom Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Kardiologiia. 55(6) |
| ISSN: | 0022-9040 |
| Popis: | We performed simultaneous coronary artery bypass grafting (CABG) and radiofrequency ablation (RFA) ostia of pulmonary veins in 254 patients (147 men and 107 women) with ischemic heart disease and paroxysmal atrial fibrillation (AF). In-hospital mortality in patients with early recurrence of AF was 8.4%, in patients without recurrence of AF 1.9% (χ2 = 4.65; p = 0.03). The patients were followed-up during 12 months after operation. During follow-up 166 patients (69.5%) had no recurrence of AF without receiving antiarrhythmic drugs (AAP), 33 patients (13.8%) had recurrences of AF, and 40 patients (16.7%) receiving AAD had repeated rare paroxysms of AF. Main predictors of late AF recurrence were age65 years, AF duration5 years, preoperative atrial effective refractory period240 ms, frequency threshold of AF induction400 counts/min, anteroposterior left atrial size50 mm, glomerular filtration rate60 ml/min/1.73 m2. Reverse dynamics of structural, functional and electrophysiological parameters of the heart due to CABG and RFA, use of β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists were associated with the preservation of a stable sinus rhythm. The cardiovascular mortality during 12 months follow-up accounted for 2.1% and 1.2% in groups of patients with and without late recurrences of AF respectively (p0.05) to coronary artery bypass grafting surgery and RFA, taking drugs--β-blockers, angiotensin converting enzyme inhibitors and aldosterone antagonists--were associated with the preservation of a stable sinus rhythm. |
| Databáze: | OpenAIRE |
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