Objectives: Atrial fibrillation (AF) is very common in patients undergoing open heart surgery. AF ablation with different sources of energy, enables the surgeon to create linear lesions rapidly and safely. However, results of these technologies need examination. We report the clinical results obtained in a 4-year experience using mono- and bipolar radiofrequency (RF) ablation of AF in a heterogeneous group of 183 patients.
Methods: From May 2001 until December 2005 a total of 183 patients underwent pulmonary vein isolation using RF energy. In 73 cases, monopolar RF was used. Energy was applied in the endocardium in 40 cases (Group A) and in the epicardium in 33 cases (Group B). From May 2003, bipolar RF was used in a total of 110 patients (Group C). Duration of AF, left atrial dimensions, age or reoperations, were not considered contraindications to ablation. Ablation procedure for AF ablation was associated with a variety of cardiac procedures, from isolated mitral valve procedure to complex ascending aorta operations.
Results: In-hospital mortality was 3.8% in the whole group (range 2.7-6.1%). Mortality and morbidity were not related with the ablation procedure. At the follow-up time of 50.9+/-3.3, 48.2+/-3.1, 32.7+/-0.9 months (Group A, B and C, respectively), sinus rhythm (SR) is present in a percentage of 75%, 67.7%, 79.4% of patients. Higher incidence of AF recurrence occurred in the first six months after surgery in all three groups. Late recurrence was higher in the epicardial group and overall freedom of AF was 64% in Group A, 46% in Group B and 71.1% in Group C (P=0.01).
Conclusions: Our results demonstrate that the epicardial monopolar RF ablation obtains worse results than the endocardial monopolar RF and the bipolar RF ablation. Bipolar RF theoretically grants transmurality and is easy and safe, and a complete ablation setting lines can be achieved. Bipolar RF enables extension of ablation to every patient on AF undergoing a cardiac operation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1510/icvts.2006.136663 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Optimized workflow with hybrid (very) high-power short-duration radiofrequency ablation renders point-by-point pulmonary vein isolation as fast and effective as cryoballoon ablation.
J Interv Card Electrophysiol
January 2025
Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC, Rotterdam, the Netherlands.
Introduction: A hybrid approach with very high-power short-duration (vHPSD) posteriorly and ablation-index guided HPSD (50 W) anteriorly seems to be an optimal balance between efficiency and effectiveness for point-by-point pulmonary vein isolation (PVI). The aim of the current study is to compare vHPSD/HPSD ablation to cryoballoon ablation (CBA) in patients with symptomatic atrial fibrillation (AF).
Methods And Results: In this retrospective single-center study, we identified 110 consecutive patients who underwent their first PVI with either vHPSD/HPSD (n = 54) or CBA (n = 56).
Vascular Balloon-Assisted Lysis of Pericardial Adhesions to Facilitate Epicardial Ventricular Tachycardia Ablation.
JACC Clin Electrophysiol
December 2024
Cardiac Arrhythmia Service, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Surgical and Ablation Therapies for Atrial Appendage Tachycardia in Children.
JACC Clin Electrophysiol
December 2024
Department of Pediatric Cardiology, Heart Center, First Hospital of Tsinghua University (Beijing Huaxin Hospital), Chaoyang District, Beijing, China.
Background: Atrial tachycardia (AT) originate from the atrial appendage present unique clinical challenges in pediatrics. It is typically persistent, frequently leading to tachycardiomyopathy, and poses significant treatment difficulties.
Objectives: This study aimed to collate and analyze the clinical characteristics and therapeutic outcomes of radiofrequency ablation (RFCA) and with atrial appendage resection for the treatment of AT originating from the atrial appendages in pediatric patients.
Subclavian Ansae Stimulation on Cardiac Hemodynamics and Electrophysiology in Atrial Fibrillation: A Target for Sympathetic Neuromodulation.
JACC Clin Electrophysiol
December 2024
St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; William Harvey Research Institute, Queen Mary University of London, London, United Kingdom. Electronic address:
Background: The sympathetic autonomic nervous system plays a major role in arrhythmia development and maintenance. Historical preclinical studies describe preferential increases in cardiac sympathetic tone upon selective stimulation of the subclavian ansae (SA), a nerve cord encircling the subclavian artery.
Objectives: This study sought to define, for the first time, the functional anatomy and physiology of the SA in humans using a percutaneous approach.
Correlation Between Voltage and Impedance Mapping in Patients with Atrial Fibrillation.
J Clin Med
December 2024
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Italy.
Pulmonary vein isolation (PVI) represents the cornerstone of paroxysmal (PAF) and persistent atrial fibrillation (PsAF) ablation. Impedance values provide insights on tissue conductive properties. Consecutive patients undergoing PAF and PsAF ablation were prospectively enrolled.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!