Objective To compare short-term clinical outcomes of bipolar/unipolar radiofrequency （RF） ablation for the treatment of permanent atrial fibrillation（AF） of patients with rheumatic valvular heart disease. Methods Clinicaldata of 124 patients with rheumatic valvular heart disease and permanent AF who underwent heart valve replacement and concomitant bipolar/unipolar RF ablation in Wuhan Asia Heart Hospital from February 2011 to December 2011 were retros- pectively analyzed. According to different RF ablation methods，all the 124 patients were divided into bipolar group and unipolar group. There were 62 patients in the bipolar group including 29 males and 33 females with their age of 44.20±8.61 years，and 62 patients in the unipolar group including 33 males and 29 females with their age of 46.40±9.48 years. Electrocardiogram examinations were performed at the time of intraoperative heart re-beating，the very postoperative day，7 days，1 month，3 months and 6 months postoperatively to detect restoration of sinus rhythm. Results There was no in-hospital death or ablation-related complication in either group. Aortic cross-clamp time（70.05±22.02 min vs. 54.47±20.65 min，P=0.025） and RF ablation time（25.12±3.00 min vs. 15.70±3.02 min，P=0.000）of the bipolar group were significantly longer than those of the unipolar group. At the time of intraoperative heart re-beating，the lst and 7th day after operation， sinus rhythm restoration rates were 88.71%，87.10%，80.65% respectively in the bipolar group，85.48%，77.42%，72.58% respectively in the unipolar group，and there was no statistical difference between the two groups （P＞0.05）. In the 1st，3rd and 6th postoperative month，sinus rhythm restoration rates of the bipolar group （79.03%，75.81%，72.58% respectively） were significantly higher than those of the unipolar group （59.68%，50.00%，48.38% respectively，P＜0.05）. Conclusion Clinical outcomes of RF ablation for the treatment of permanent AF of patients with rheumatic valvular heart disease are satisfactory. Unipolar RF ablation has the advantage of being time-saving and easier technique，while short-term sinus rhythm restoration rate of bipolar RF ablation is higher than that of unipolar RF ablation for the treatment of permanent AF.
Citation：
FU Jun,WANG Bo,TAO Liang,CHEN Xufa,YAN Huifeng.. Comparison of Clinical Outcomes of Two Different Radiofrequency Ablation for the Treatment of Permanent Atrial Fibrillation of Patients with Rheumatic Valvular Heart Disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(3): 304-307. doi: 10.7507/1007-4848.20130092
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Copyright © the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
| 1. |
Voeller RK， Schuessler RB， Damiano RJ， Chief editor. Surgical treatment of atrial fibrillation. In： Cohn LH， ed. Cardiac Surgery in the Adult. New York： McGraw Hill， 2008.1375-1394.
|
| 2. |
Cox JL， Schuessler RB， D’Agostino HJ Jr， et al. The surgical treatment of atrial fibrillation.Ⅲ. Development of a definitive surgicalprocedure. J Thorac Cardiovasc Surg， 1991， 101 （4）：569–583.
|
| 3. |
Benussi S， Cini R， Gaynor SL， et al. Bipolar radiofrequency maze procedure through a transseptal approach. Ann Thorac Surg， 2010， 90 （3）： 1025-1027.
|
| 4. |
王磊， 舒礼良， 苏刚， 等. 射频消融加左房折叠治疗慢性房颤瓣膜病. 中华胸心血管外科杂志， 2012， 28 （2）：99-100.
|
| 5. |
张大国， 刘秀伦， 范寿年， 等. 换瓣术中单极、双极射频消融治疗风心病房颤的临床研究. 贵州医药， 2011， 35 （7）：579-581.
|
| 6. |
刘玉学， 王巍， 王欣， 等. 心房纤维化程度对风湿性心脏病永久性心房颤动射频消融治疗疗效的影响. 中国胸心血管外科临床杂志， 2010， 17 （4）：267-272.
|
| 7. |
刘健， 黄击修， 林小彬， 等. 不中断冠脉循环下直视双极射频消融治疗心房颤动. 中国胸心血管外科临床杂志， 2010， 17 （5）：425-427.
|
| 8. |
修宗谊， 谷天祥， 马瑞阳. 心脏瓣膜置换术中射频消融治疗心房颤动. 中国胸心血管外科临床杂志， 2009， 16 （3）：246-246.
|
| 9. |
王辉山， 汪曾炜， 李新民， 等. 双极射频消融迷宫术后同步电复律治疗心房颤动. 中国胸心血管外科临床杂志， 2011， 18 （4）：359-361.
|
| 10. |
von Oppell UO， Masani N， O'Callaghan P， et al. Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy. Eur J Cardiothorac Surg， 2009， 35 （4）：641-650.
|
| 11. |
杨嵩， 张希， 唐白云， 等. 永久性心房颤动外科双极射频消融术的效果. 中国胸心血管外科临床杂志， 2012， 19 （3）：254-257.
|
| 12. |
Kubota S， Sugiki H， Wakasa S， et al. Can we change the operative criteria for the Maze procedure combined with valve surgery in the era of radiofrequency devices? Gen Thorac Cardiovasc Surg， 2011， 59 （6）： 406-412.
|
| 13. |
周勇， 李莉， 徐志云等. 瓣膜置换同时射频消融隔离肺静脉治疗风湿性瓣膜性心脏病永久性房颤. 中华老年多器官疾病杂志， 2009， 8 （1）：32-34.
|
| 14. |
Lo LW， Tai CT， Lin YJ， et al. Characteristics of the cavotricuspid isthmus in predicting recurrent conduction in the long-term follow-up.J Cardiovasc Electrophysiol， 2009， 20 （1）： 39-43.
|
| 15. |
Wang JG， Meng X， Li H， et al. Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation. Eur J Cardiothorac Surg， 2009， 35 （1）： 116-122.
|
| 16. |
Aktas MK， Khan MN， Di Biase L， et al. Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery. J Cardiovasc Electrophysiol， 2010， 21 （7）： 760-765.
|
| 17. |
Falk RH.Atrial fibrillation. N Engl J Med， 2001， 344 （14）：1067-1078.
|
| 18. |
许铭. 心房颤动的外科治疗现状. 中国循环杂志， 2010， 25 （2）：154-156.
|
| 19. |
李毅刚， 王群山， 俞洁霏， 等. 慢性房颤的导管消融进展. 上海交通大学学报：医学版， 2008， 28 （10）：1211-1218.
|
| 20. |
Cox JL， Boineau JP， Schuessler RB， et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. I. Rationale and surgical results. J Thorac Cardiovasc Surg， 1995， 110 （2）：473-484.
|
- 1. Voeller RK， Schuessler RB， Damiano RJ， Chief editor. Surgical treatment of atrial fibrillation. In： Cohn LH， ed. Cardiac Surgery in the Adult. New York： McGraw Hill， 2008.1375-1394.
- 2. Cox JL， Schuessler RB， D’Agostino HJ Jr， et al. The surgical treatment of atrial fibrillation.Ⅲ. Development of a definitive surgicalprocedure. J Thorac Cardiovasc Surg， 1991， 101 （4）：569–583.
- 3. Benussi S， Cini R， Gaynor SL， et al. Bipolar radiofrequency maze procedure through a transseptal approach. Ann Thorac Surg， 2010， 90 （3）： 1025-1027.
- 4. 王磊， 舒礼良， 苏刚， 等. 射频消融加左房折叠治疗慢性房颤瓣膜病. 中华胸心血管外科杂志， 2012， 28 （2）：99-100.
- 5. 张大国， 刘秀伦， 范寿年， 等. 换瓣术中单极、双极射频消融治疗风心病房颤的临床研究. 贵州医药， 2011， 35 （7）：579-581.
- 6. 刘玉学， 王巍， 王欣， 等. 心房纤维化程度对风湿性心脏病永久性心房颤动射频消融治疗疗效的影响. 中国胸心血管外科临床杂志， 2010， 17 （4）：267-272.
- 7. 刘健， 黄击修， 林小彬， 等. 不中断冠脉循环下直视双极射频消融治疗心房颤动. 中国胸心血管外科临床杂志， 2010， 17 （5）：425-427.
- 8. 修宗谊， 谷天祥， 马瑞阳. 心脏瓣膜置换术中射频消融治疗心房颤动. 中国胸心血管外科临床杂志， 2009， 16 （3）：246-246.
- 9. 王辉山， 汪曾炜， 李新民， 等. 双极射频消融迷宫术后同步电复律治疗心房颤动. 中国胸心血管外科临床杂志， 2011， 18 （4）：359-361.
- 10. von Oppell UO， Masani N， O'Callaghan P， et al. Mitral valve surgery plus concomitant atrial fibrillation ablation is superior to mitral valve surgery alone with an intensive rhythm control strategy. Eur J Cardiothorac Surg， 2009， 35 （4）：641-650.
- 11. 杨嵩， 张希， 唐白云， 等. 永久性心房颤动外科双极射频消融术的效果. 中国胸心血管外科临床杂志， 2012， 19 （3）：254-257.
- 12. Kubota S， Sugiki H， Wakasa S， et al. Can we change the operative criteria for the Maze procedure combined with valve surgery in the era of radiofrequency devices? Gen Thorac Cardiovasc Surg， 2011， 59 （6）： 406-412.
- 13. 周勇， 李莉， 徐志云等. 瓣膜置换同时射频消融隔离肺静脉治疗风湿性瓣膜性心脏病永久性房颤. 中华老年多器官疾病杂志， 2009， 8 （1）：32-34.
- 14. Lo LW， Tai CT， Lin YJ， et al. Characteristics of the cavotricuspid isthmus in predicting recurrent conduction in the long-term follow-up.J Cardiovasc Electrophysiol， 2009， 20 （1）： 39-43.
- 15. Wang JG， Meng X， Li H， et al. Prospective randomized comparison of left atrial and biatrial radiofrequency ablation in the treatment of atrial fibrillation. Eur J Cardiothorac Surg， 2009， 35 （1）： 116-122.
- 16. Aktas MK， Khan MN， Di Biase L， et al. Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery. J Cardiovasc Electrophysiol， 2010， 21 （7）： 760-765.
- 17. Falk RH.Atrial fibrillation. N Engl J Med， 2001， 344 （14）：1067-1078.
- 18. 许铭. 心房颤动的外科治疗现状. 中国循环杂志， 2010， 25 （2）：154-156.
- 19. 李毅刚， 王群山， 俞洁霏， 等. 慢性房颤的导管消融进展. 上海交通大学学报：医学版， 2008， 28 （10）：1211-1218.
- 20. Cox JL， Boineau JP， Schuessler RB， et al. Modification of the maze procedure for atrial flutter and atrial fibrillation. I. Rationale and surgical results. J Thorac Cardiovasc Surg， 1995， 110 （2）：473-484.
