Document Detail


Intra-operative cooled-tip radiofrequency linear atrial ablation to treat permanent atrial fibrillation.
MedLine Citation:
PMID:  17956873     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To demonstrate the safety and efficacy of saline irrigated cooled-tip atrial linear endocardial radiofrequency ablation (SICTRA) concomitant to open-heart surgical procedures in the treatment of permanent atrial fibrillation (AF). METHODS AND RESULTS: Two hundred and twenty-two patients presenting with permanent AF and the need for cardiac surgery were included. In addition to the cardio-surgical procedure [mitral valve (MV) surgery (n = 94), aortic valve replacement (n = 29), bypass surgery (n = 76 including 24 patients with additional MV surgery), and combined procedures (n = 23)] concomitant SICTRA was performed. In 116 patients, the ablation pattern was restricted to the left atrium alone. During the mean follow-up of 29 months, 174 patients (78%) converted to sinusrhythm (SR). In patients with SICTRA restricted to the left atrium conversion rates were not different compared to a biatrial approach (83 vs. 74%, P = 0.47). Thirty-days mortality was found to be 4% (9/222). Post-mortem evaluation revealed 23% of all lesions to be histologically non-transmural. In the overall group, only 4% of patients developed sustained secondary regular atrial arrhythmia. CONCLUSIONS: SICTRA safely and effectively restores stable SR in 78% of patients with permanent AF undergoing open-heart surgery. Rhythm outcome is not influenced by treatment of the right atrium. Sustained regular atrial arrhythmia with the need for invasive treatment strategies occurs in 4% although intra-operative ablation lesions are often non-transmural.
Authors:
Thomas Deneke; Krishna Khargi; Bernd Lemke; Thomas Lawo; Michael Lindstaedt; Alfried Germing; Turgut Brodherr; Leif Bösche; Andreas Mügge; Axel Laczkovics; Peter H Grewe; Markus Fritz
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-10-23
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2909-14     Citation Subset:  IM    
Affiliation:
University Heart Center Bochum, BG University-Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. thomas.deneke@rub.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve / transplantation
Atrial Fibrillation / mortality,  surgery*
Catheter Ablation / instrumentation*,  methods
Combined Modality Therapy / methods
Coronary Artery Bypass / methods
Follow-Up Studies
Humans
Intraoperative Period
Middle Aged
Mitral Valve / surgery

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


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