医学
心房颤动
胺碘酮
窦性心律
心脏病学
烧蚀
内科学
相伴的
心脏外科
外科
人口
作者
Stephan Geidel,Michael Lass,Sigrid Boczor,Karl-Heinz Kuck,J. Ostermeyer
出处
期刊:Heart Surgery Forum
[Carden Jennings Publishing Co.]
日期:2004-01-01
卷期号:7 (5): 398-402
被引量:10
标识
DOI:10.1532/hsf98.20041054
摘要
OBJECTIVE In our population, permanent atrial fibrillation (pAF) is a serious concomitant problem in patients scheduled for open heart surgery. The high incidence necessitates reliable methods of treating pAF efficiently. We report our 3-year experience with a safe concept of using monopolar and bipolar radiofrequency (RF) ablation procedures. METHODS Ninety patients (mitral, n = 56; aortic, n = 22; aortic and mitral, n = 1; coronary artery bypass grafting, n = 11) underwent either monopolar (n = 77) or, recently, bipolar (n = 13) RF ablation procedures that produced encircling isolation lesions around the left and the right pulmonary veins (PVs) and a connection line between the two. Amiodarone was given for 3 months after surgery. RESULTS Hospital mortality was 2.2%. At follow-up, 75% of the patients were in stable sinus rhythm (SR). Preoperative pAF duration, etiology of heart disease, and type of RF energy application were not predictive of the risk of persisting pAF after surgery. Whereas patients (50 of 90) with small preoperative left atrial (LA) diameters ( or=56 mm; 40 of 90 patients) were associated with a significant risk of persisting pAF (P < .05). CONCLUSION Particularly in cases of small preoperative LA diameters, isolation of the PVs using either monopolar or bipolar RF ablation procedures in combination with amiodarone therapy represents a safe and efficient option for curing pAF in patients undergoing open heart surgery.
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