Document Detail


Atrial flutter after surgical radiofrequency ablation of the left atrium for atrial fibrillation.
MedLine Citation:
PMID:  15620925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left atrial radiofrequency ablation is the most common technique for the treatment of atrial fibrillation during mitral valve surgery. Reported failure rates range between 15% and 30%, with some patients remaining in atrial fibrillation and others experiencing atrial flutter. The incidence and nature of the postoperative atrial flutter is not yet well defined. METHODS: The study group consisted of 50 patients with atrial fibrillation who underwent mitral valve surgery combined with left atrial radiofrequency ablation, and were followed for a mean period of 15 +/- 7 months. The majority of patients (39; 78%) had persistent or permanent atrial fibrillation. Placement of the ablation lines was as follows: encircling the pulmonary veins, isolating the base of the left atrial appendage, and bridging the lateral or posterior mitral annulus and the margin of the pulmonary vein or the appendage-encircling ablation lines. RESULTS: There were three hospital deaths (6%). Thirty-four (72%) patients were free of any atrial tachyarrhythmia events, and 37 (79%) patients were in sinus rhythm by the end of the study's follow-up. During the follow-up, 6 patients (12.7%) experienced atrial flutter and 1 patient had atrial tachycardia. Electrophysiologic study was performed in 5 of 6 patients with postoperative atrial flutter. In 4 of them, the study findings were consistent with left atrial flutter. One patient with typical isthmus-dependent right atrial flutter underwent successful ablation. CONCLUSIONS: Left atrial surgical radiofrequency ablation is associated with a high rate of postoperative atrial flutters that appear to be predominantly of left-sided origin.
Authors:
Gregory Golovchiner; Alexander Mazur; Alex Kogan; Boris Strasberg; Yaron Shapira; Menachem Fridman; Jairo Kuzniec; Bernardo A Vidne; Ehud Raanani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  79     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-28     Completed Date:  2005-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  108-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Rabin Medical Center, Petah Tiqwa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / etiology,  surgery*
Atrial Flutter / epidemiology*,  etiology
Cardiomyopathy, Hypertrophic / complications,  surgery
Catheter Ablation*
Female
Follow-Up Studies
Heart Atria / surgery
Heart Valve Prosthesis Implantation*
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Mitral Valve / surgery
Mitral Valve Insufficiency / complications,  surgery*
Postoperative Complications / epidemiology*,  etiology
Rheumatic Heart Disease / complications,  surgery
Treatment Outcome
Tricuspid Valve Insufficiency / complications,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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