Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation
| Autor: | Yong-qiang Cui, Jiangang Wang, Hui Li, Xu Meng, Jie Han, Chunlei Xu |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Heart disease Radiofrequency ablation medicine.medical_treatment law.invention Intraoperative Period Young Adult Postoperative Complications Recurrence law Internal medicine Atrial Fibrillation medicine Cardiopulmonary bypass Humans Sinus rhythm Heart Atria Aged Cardiopulmonary Bypass business.industry Atrial fibrillation General Medicine Middle Aged Ablation medicine.disease Surgery Cardiac surgery Stroke Treatment Outcome Concomitant Catheter Ablation Cardiology Female Epidemiologic Methods Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 35:116-122 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2008.09.014 |
| Popis: | Objective: The aim of this study was to compare, in patients with permanent atrial fibrillation (AF), the efficacy and safety of left atrial ablation with that of a biatrial procedure and to assess the risk factors for late failure of sinus rhythm restoration. Methods: Between January 2004 and January 2007, 299 consecutive patients underwent the radiofrequency ablation procedure for AF associated with concomitant cardiac surgery. Accordingto a prospective,open, and randomized trial, 149 patients underwentleft atrial plus cavotricuspid isthmus ablation (left atrial group), while 150 patients underwent biatrial ablation (biatrial group). The postoperative and mid-term follow-up results were compared between the two groups. Both univariate and multivariate analyses were used to assess the risk factors for late recurrence of AF. Results: There were seven in-hospital deaths (2.3%), including two in the left atrial group (1.3%) and five in the biatrial group (3.3%), and there were no differences in the incidenceof the mortality and complications during the postoperative and follow-up periods betweenthe groups. At discharge, sinus rhythm was maintained in 77.1% of the patients, including 78.2% of those in the left atrial group and 75.9% in the biatrial group (p = 0.68). Follow-up was completed in 97% of the patients, with a mean time of 28 5 months. At the latest follow-up, two deaths occurred in the biatrial group. Sinus rhythm was documented in 237 (85.0%) out of all the patients, including 85.2% (121/142) in the left atrial group and 84.1% (116/138) in the biatrial group patients (p = 0.87). Using a multivariate analysis, a left atrial diameter of 80 mm (p = 0.02) was an independent predictor for a late recurrenceof AF.Conclusions:Boththe leftatrialcombinedwith cavotricuspid isthmus ablationandbiatrialmaze procedure is safe and effective in treating patients with AF, with an acceptable sinus conversion rate, mortality and morbidity. A left atrial dimension of 80 mm was a significant predictor for a late recurrence of AF. # 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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