RT-96
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Treatment of atrial fibrillation during mitral valve surgery
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Stefano Benussi, Ottavio Alfieri.
Cardiac Surgery Division, S. Raffaele Hospital, Milan, Italy
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Abstract
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BACKGROUND. Recovery of sinus rhythm after
mitral valve surgery in patients with chronic atrial fibrillation (AF) lowers
thromboembolic risk and improves survival. Traditional AF surgery is technically
demanding and increases operative morbidity. Simplified techniques have been
developed in the last years to treat the arrhythmia in patients undergoing mitral valve
surgery. Intraoperative radiofrequency ablation has recently proven extremely effective
in AF surgery, allowing a further simplification of the procedures.
METHODS. We developed an original radiofrequency ablation technique for
combined AF treatment during mitral valve surgery. A left atrial radiofrequency
lesion set comprising a separate encircling of left and right pulmonary veins is
performed almost completely from the epicardial surface on the beating heart, before
aortic cross clamping.
RESULTS. Forty-five patients with chronic atrial fibrillation underwent combined
radiofrequency ablation and mitral valve surgery. No procedure-related complication
occurred. No significant increase of operative times and postoperative bleeding was
recorded. At 10 months follow-up 77% of the patients were in stable sinus rhythm. All
patients in sinus rhythm recovered both left and right atrial contractility.
CONCLUSIONS. Epicardial radiofrequency is a safe and effective mean to treat AF.
Combined AF ablation should be performed on a routine basis in patients undergoing
mitral valve surgery.
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Key Words
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