Radiofrequency Catheter Ablation for Atrial Tachycardia in Patients after Radiofrequency Ablation of Atrial Fibrillation during Mitral Valve Replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 YANGQing , ZENGLi-jun

Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

YANGQing, Email: westxiaoyu@vip.sina.com

Keywords：

Atrial tachycardia; Mitral valve replacement; Radiofrequency ablation

DOI：

10.7507/1007-4848.20140101

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate heart rhythm outcomes of radiofrequency ablation (RFA)of atrial fibrillation (AF)during mitral valve replacement (MVR)for patients with rheumatic heart disease (RHD), and explore clinical results of radiofrequency catheter ablation (RFCA)for postoperative atrial tachycardia (AT). Methods Eleven RHD patients who developed AT after RFA of AF during MVR were enrolled in this study. There were 4 males and 7 females with their age of 49±8 years. Electroanatomic mapping of the left or right atrium was conducted with three-dimensional electroana-tomic mapping system during continuous AT. RFCA was performed at the key areas of AT. Results For MVR, operation time was 149±18 minutes, postoperative hospital stay was 9.5±2.9 days, and length of ICU stay was 1.8±0.4 days. During electroanatomic mapping, 17 ATs were recorded in 11 patients. Six ATs (35%)of 5 patients originated from the right atrium and 11 ATs (65%)of 6 patients originated from the left atrium (LA). Among them, AT of 2 patients was related to the mitral valve ring. Immediate success of RFCA was obtained in 91% (10/11). After a mean follow-up of 17±4 months, 2 patients whose AT originated from LA had AT recurrence. Conclusions Majority of postoperative ATs originate from LA, and majority of ATs are not mitral-dependent. RFCA is an effective and safe procedure for AT in patients after RFA of AF during MVR.

Citation： YANGQing, ZENGLi-jun. Radiofrequency Catheter Ablation for Atrial Tachycardia in Patients after Radiofrequency Ablation of Atrial Fibrillation during Mitral Valve Replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(3): 367-370. doi: 10.7507/1007-4848.20140101 Copy

1.	Gelatt M, Hamilton RM, Mccrindle BW, et al. Arrhythmia and mortality after the Mustard procedure:a 30-year single-center experience. J Am Coll Cardiol, 1997, 29 (1):194-201.
2.	Triedman JK. Arrhythmias in adults with congenital heart disease. Heart, 2002, 87 (4):383-389.
3.	Anné W, Van Rensburg H, Adams J, et al. Ablation of post-surgical intra-atrial reentrant tachycardia. Predilection target sites and mapping approach.Eur Heart J, 2002, 23 (20):1609-1616.
4.	Carapetis JR. Rheumatic heart disease in Asia. Circulation, 2008, 118 (25):2748-2753.
5.	彭晓兰, 吴玉蕊, 谢慧能.近20年风湿热及风湿性心脏病发病的回顾性分析(附470例报告).海南医学, 2002, 13 (3):1-2.
6.	李莉.心房颤动外科治疗十年回顾.中华心律失常学杂志, 2008, 12 (z1):31-35.
7.	Bogachev-Prokophiev A, Zheleznev S, Romanov A, et al. Ablation for atrial fibrillation during mitral valve surgery:1-year results through continuous subcutaneous monitoring. Interact Cardiovasc Thorac Surg, 2012, 15 (1):37-41.
8.	Kim JB, Ju MH, Yun SC, et al. Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation. Heart, 2010, 96 (14):1126-1131.
9.	Cox JL, Schuessler RB, D'agostino JJ, et al. The surgical treatment of atrial fibrillation.Ⅲ. Development of a definitive surgical procedure. J Thorac Cardiovas Surg, 1991, 101 (4):569-583.
10.	Cox JL, Jaquiss RB, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation:Ⅱ. Surgical technique of the mazeⅢprocedure. J Thorac Cardiovascular Surg, 1995, 110 (2):485-495.
11.	李菲, 孟旭.术前左心房内径对外科射频消融术治疗心房颤动疗效的影响.中国胸心血管外科临床杂志, 2013, 20 (1):38-42.
12.	Ruchat P, Schlaepfer J, Delabays A, et al. Left atrial radiofrequency compartmentalization for chronic atrial fibrillation during heart surgery. Thorac Cardiovasc Surg, 2002, 50 (3):155-159.
13.	Stulak JM, Sundt TM, Dearani JA, et al. Ten-year experience with the Cox-maze procedure for atrial fibrillation:how do we define success? Ann Thorac Surg, 2007, 83 (4):1319-1324.
14.	John B, Stiles MK, Kuklik P, et al. Electrical remodelling of the left and right atria due to rheumatic mitral stenosis. Eur Heart J, 2008, 29 (18):2234-2243.
15.	Deedwania P, Huang Gw. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation. Core evidence, 2012, 7:49.
16.	Albrecht Á, Kalil RK, Schuch L, et al. Randomized study of surgical isolation of the pulmonary veins for correction of permanent atrial fibrillation associated with mitral valve disease. J Thorac Cardiovasc Surg, 2009, 138 (2):454-459.

1. Gelatt M, Hamilton RM, Mccrindle BW, et al. Arrhythmia and mortality after the Mustard procedure:a 30-year single-center experience. J Am Coll Cardiol, 1997, 29 (1):194-201.
2. Triedman JK. Arrhythmias in adults with congenital heart disease. Heart, 2002, 87 (4):383-389.
3. Anné W, Van Rensburg H, Adams J, et al. Ablation of post-surgical intra-atrial reentrant tachycardia. Predilection target sites and mapping approach.Eur Heart J, 2002, 23 (20):1609-1616.
4. Carapetis JR. Rheumatic heart disease in Asia. Circulation, 2008, 118 (25):2748-2753.
5. 彭晓兰, 吴玉蕊, 谢慧能.近20年风湿热及风湿性心脏病发病的回顾性分析(附470例报告).海南医学, 2002, 13 (3):1-2.
6. 李莉.心房颤动外科治疗十年回顾.中华心律失常学杂志, 2008, 12 (z1):31-35.
7. Bogachev-Prokophiev A, Zheleznev S, Romanov A, et al. Ablation for atrial fibrillation during mitral valve surgery:1-year results through continuous subcutaneous monitoring. Interact Cardiovasc Thorac Surg, 2012, 15 (1):37-41.
8. Kim JB, Ju MH, Yun SC, et al. Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation. Heart, 2010, 96 (14):1126-1131.
9. Cox JL, Schuessler RB, D'agostino JJ, et al. The surgical treatment of atrial fibrillation.Ⅲ. Development of a definitive surgical procedure. J Thorac Cardiovas Surg, 1991, 101 (4):569-583.
10. Cox JL, Jaquiss RB, Schuessler RB, et al. Modification of the maze procedure for atrial flutter and atrial fibrillation:Ⅱ. Surgical technique of the mazeⅢprocedure. J Thorac Cardiovascular Surg, 1995, 110 (2):485-495.
11. 李菲, 孟旭.术前左心房内径对外科射频消融术治疗心房颤动疗效的影响.中国胸心血管外科临床杂志, 2013, 20 (1):38-42.
12. Ruchat P, Schlaepfer J, Delabays A, et al. Left atrial radiofrequency compartmentalization for chronic atrial fibrillation during heart surgery. Thorac Cardiovasc Surg, 2002, 50 (3):155-159.
13. Stulak JM, Sundt TM, Dearani JA, et al. Ten-year experience with the Cox-maze procedure for atrial fibrillation:how do we define success? Ann Thorac Surg, 2007, 83 (4):1319-1324.
14. John B, Stiles MK, Kuklik P, et al. Electrical remodelling of the left and right atria due to rheumatic mitral stenosis. Eur Heart J, 2008, 29 (18):2234-2243.
15. Deedwania P, Huang Gw. An evidence-based review of apixaban and its potential in the prevention of stroke in patients with atrial fibrillation. Core evidence, 2012, 7:49.
16. Albrecht Á, Kalil RK, Schuch L, et al. Randomized study of surgical isolation of the pulmonary veins for correction of permanent atrial fibrillation associated with mitral valve disease. J Thorac Cardiovasc Surg, 2009, 138 (2):454-459.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Radiofrequency Catheter Ablation for Atrial Tachycardia in Patients after Radiofrequency Ablation of Atrial Fibrillation during Mitral Valve Replacement

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