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Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasoundin patients with mitral valve disease, considering preoperative clinicalcharacteristics of patients undergoing surgical procedure and follow-up inthe immediate postoperative period, in hospital and up to 60 months afterdischarge.

Methods: We studied 100 patients with chronic atrial fibrillation and mitral valvedisease who underwent surgical treatment using ultrasound ablation. Patientdata were reviewed by consulting the control reports, including signs andsymptoms, underlying disease, functional class, hospital stay, surgicalprocedure time, ablation time, immediate complications, and complications atdischarged and up to 60 months later. Actuarial curve (Kaplan-Meier) wasused for the study of permanence without recurrence after 12, 24, 36, 48 and60 months.

Results: 86% of the patients had rheumatic mitral valve disease, 14% had degenerationof the mitral valve, 40% had mitral regurgitation, and 36% had mitralstenosis. Main symptoms included palpitations related to tachycardia bychronic atrial fibrillation (70%), congestive heart failure (70%), andprevious episodes of acute pulmonary edema (27%). Early results showed that94% of the patients undergoing ultrasound ablation reversed the rate ofchronic atrial fibrillation, 86% being in sinus rhythm and 8% inatrioventricular block. At hospital discharge, maintenance of sinus rhythmwas observed in 86% of patients and there was recurrence of chronic atrialfibrillation in 8% of patients. At follow-up after 60 months, 83.8% ofpatients maintained the sinus rhythm.

Conclusion: Surgical treatment of chronic atrial fibrillation with ultrasound concomitantwith mitral valve surgery is feasible and satisfactory, with maintenance ofsinus rhythm in most patients (83.8%) after 60 months of follow-up.

No MeSH data available.


Related in: MedlinePlus

Percentage distribution of symptoms and functional class in patients withchronic atrial fibrillation.
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f2: Percentage distribution of symptoms and functional class in patients withchronic atrial fibrillation.

Mentions: Main symptoms included palpitations related to tachycardia by CAF (70%), congestiveheart failure (70%), previous episodes of acute pulmonary edema (27%), stroke due tothromboembolism (13%), and peripheral embolism (7%); these patients requiredembolectomy with Fogarty catheter (Figure 2).The functional class of patients, according to New York Heart Association (NYHA),was III/IV and the average size of the left atrium measured on echocardiography wasapproximately 60 mm.


Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery
Percentage distribution of symptoms and functional class in patients withchronic atrial fibrillation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5382896&req=5

f2: Percentage distribution of symptoms and functional class in patients withchronic atrial fibrillation.
Mentions: Main symptoms included palpitations related to tachycardia by CAF (70%), congestiveheart failure (70%), previous episodes of acute pulmonary edema (27%), stroke due tothromboembolism (13%), and peripheral embolism (7%); these patients requiredembolectomy with Fogarty catheter (Figure 2).The functional class of patients, according to New York Heart Association (NYHA),was III/IV and the average size of the left atrium measured on echocardiography wasapproximately 60 mm.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasoundin patients with mitral valve disease, considering preoperative clinicalcharacteristics of patients undergoing surgical procedure and follow-up inthe immediate postoperative period, in hospital and up to 60 months afterdischarge.

Methods: We studied 100 patients with chronic atrial fibrillation and mitral valvedisease who underwent surgical treatment using ultrasound ablation. Patientdata were reviewed by consulting the control reports, including signs andsymptoms, underlying disease, functional class, hospital stay, surgicalprocedure time, ablation time, immediate complications, and complications atdischarged and up to 60 months later. Actuarial curve (Kaplan-Meier) wasused for the study of permanence without recurrence after 12, 24, 36, 48 and60 months.

Results: 86% of the patients had rheumatic mitral valve disease, 14% had degenerationof the mitral valve, 40% had mitral regurgitation, and 36% had mitralstenosis. Main symptoms included palpitations related to tachycardia bychronic atrial fibrillation (70%), congestive heart failure (70%), andprevious episodes of acute pulmonary edema (27%). Early results showed that94% of the patients undergoing ultrasound ablation reversed the rate ofchronic atrial fibrillation, 86% being in sinus rhythm and 8% inatrioventricular block. At hospital discharge, maintenance of sinus rhythmwas observed in 86% of patients and there was recurrence of chronic atrialfibrillation in 8% of patients. At follow-up after 60 months, 83.8% ofpatients maintained the sinus rhythm.

Conclusion: Surgical treatment of chronic atrial fibrillation with ultrasound concomitantwith mitral valve surgery is feasible and satisfactory, with maintenance ofsinus rhythm in most patients (83.8%) after 60 months of follow-up.

No MeSH data available.


Related in: MedlinePlus