Intraoperative radiofrequency maze ablation for atrial fibrillation:: The Berlin modification

被引:73
作者
Pasic, M [1 ]
Bergs, P [1 ]
Müller, P [1 ]
Hofmann, M [1 ]
Grauhan, O [1 ]
Kuppe, H [1 ]
Hetzer, R [1 ]
机构
[1] Deutsch Herzzentrum Berlin, D-13353 Berlin, Germany
关键词
D O I
10.1016/S0003-4975(01)03069-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. The Cox-maze procedure combined with an operation for organic heart disease is highly successful in the elimination of chronic atrial fibrillation. However, it prolongs significantly the aortic cross-clamp and operating time. In this study, a simplified left atrial maze procedure, which is a short procedure performed using a surgical radiofrequency ablation probe, is added to elective open heart procedures in patients with atrial fibrillation. Methods. Forty-eight adults with atrial fibrillation (duration, 6 months to 36 years) underwent elective open heart operations (isolated valve procedures or coronary artery bypass grafting, n = 27 patients; combined procedures, n = 21 patients) combined with intraoperative radiofrequency ablation of the left atrium. The postoperative follow-up period ranged from 1 to 11 months (mean, 4 months). Possible predictors for persistent postoperative atrial fibrillation were determined among 40 variables by univariate and multivariate analyses. Results. Intraoperative radiofrequency ablation prolonged the aortic cross-clamp time for 6 to 14 minutes (mean, 11 minutes). Freedom from atrial fibrillation was 100% intraoperatively, 25% at 1 week after operation (12 of 48 patients), 59% at 1 month postoperatively (16 of 27 patients), 64% at 3 months postoperatively (16 of 25 patients), and 92% at 6 months postoperatively (12 of 13 patients). The only predictor of postoperative atrial fibrillation was the presence of coronary artery disease (odds ratio, 7.5; 80% confidence interval, 2.24-25.13). Conclusions. Intraoperative radiofrequency ablation of the left atrium combined with an operation for organic heart disease effectively eliminates atrial fibrillation without significant prolongation of the aortic cross-clamp and operative time. The presence of coronary artery disease decreases the success rate during the first 6 postoperative months. (C) 2001 by The Society of Thoracic Surgeons.
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收藏
页码:1484 / 1490
页数:7
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