Outcomes of Maze Procedure Using Bipolar Radiofrequency Ablation for Surgical Treatment of Permanent Atrial Fibrillation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Song , ZHANG Xi , TANG Baiyun

Department of Cardiac Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, P. R. China;

Corresponding author：

Keywords：

Bipolar radiofrequency ablation; Permanent atrial fibrillation; Cox Ⅳ maze

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Abstract： Objective To summarize the clinical outcomes of maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of permanent atrial fibrillation（AF） and rheumatic valve diseases. Methods A total of 124 patients with permanent AF and rheumatic valves diseases undergoing surgical treatment from March 2006 to October 2010 in the First Affiliated Hospital of Sun Yat-sen University were randomly divided into ablation group and control group using coin method with 62 patients in each group. The mean atrial fibrillation duration was（56.1±47.1） months in ablation group, and patients in this group underwent maze procedure using bipolar radiofrequency ablation and valve replacement. The mean atrial fibrillation duration was（43.8±25.6） months in control group, and patients in this group underwent only valve replacement. Demographic characteristics, cardiopulmonary bypass（CPB）time, aortic cross-clamping（ACC）time, mechanical ventilation time, intensive care unit（ICU） length of stay, postoperative complications and follow-up outcomes were compared between the two groups. Results The demographic characteristics of the two groups were not statistically different （P＞0.05）. The CPB time and ACC time between the two groups were not statistically different （P＞ 0.05）. The postoperative hospital stay of ablation group was significantly longer than that of control group （15.8±6.1 d vs. 12.9±3.1d，P=0.001）. No patient needed permanent pacemaker implantation in either group. Postoperative ejection fraction of ablation group was significantly higher than that of control group（59.6%±9.2% vs. 55.5%±5.4%，P＜ 0.01）. The rate of sinus rhythm maintenance at 6 months, 12 months, 18 months, 24 months during follow-up in ablation group were 88.5%, 87.5%, 87.1% and 82.4% respectively, 3.3%, 2.2%, 0.0%, and 0.0% in control group respectively, which was statistically different between the two groups（P＜ 0.05）. Conclusion Maze procedure using bipolar radiofrequency ablation is an effective surgical procedure for the treatment of permanent atrial fibrillation.

Citation： YANG Song,ZHANG Xi,TANG Baiyun,et al.. Outcomes of Maze Procedure Using Bipolar Radiofrequency Ablation for Surgical Treatment of Permanent Atrial Fibrillation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 254-257. doi: Copy

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15.	-592.
16.	-841.

1. 　Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics–2006 update： a report from the American Heart Association Atatistics Committee and Stroke Statistics Subcommittee. Circulation, 2006, 113 （6）： e85-e151.
2. 　Lloyd-Jones DM, Wang TJ, Leip EP, et al. Lifetime risk for development of atrial ?brillation： the framingham heart study. Circulation, 2004, 110 （9）：1042-1046.
3. 　Hu D, Sun Y. Epidemiology, risk factors for stroke, and management of atrial fibrillation in China. J Am Coll Cardiol, 2008, 52 （10）： 865-868.
4. 　Prasad SM, Maniar HS, Schuessler RB, et al. Chronic transmural atrial ablation by using bipolar radiofrequency energy on the beating heart. J Thorac Cardiovasc Surg , 2002 , 124 （4）：708-713.
5. 　Prasad SM, Maniar HS, Diodato MD, et al. Physiological consequences of bipolar radiofrequency energy on the atria and pulmonary veins： a chronic animal study. Ann Thorac Surg, 2003, 76 （3）：.
6. 　Calkins H, Brugada J, Packer DL, et al. HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation： recommendations for personnel, policy, procedures and follow-up. Europace, 2007, 9（6）： 335-379.
7. 　Abreu Filho CA, Lisboa LA, Dallan LA, et al. Effectiveness of the maze procedure using cooled-tip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease.Circulation, 2005, 112 （9 Suppl）：I20-I25.
8. 　Wang W, Guo LR, Martland AM, et al. Biatrial reduction plasty with reef imbricate technique as an adjunct to maze procedure for permanent atrial fibrillation associated with giant left atria. Interact Cardiovascular Thorac Surg, 2010, 10 （4）： 577-581.
9. 　Melby SJ, Zierer A, Bailey MS, et al. A new era in the surgical treatment of atrial fibrillation： the impact of ablation technology and lesion set on procedural efficacy. Ann Surg , 2006, 244 （4）：.
10. 　Oral H, Knight BP, Ozaydin M, et al. Clinical significance of early recurrences of atrial fibrillation after pulmonary vein isolation. J Am Coll Cardiol , 2002, 40 （1）：100-104.
11. 　Tekumit H, Uzun K, Cenal AR，et al. Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation. Cardiovasc J Afr, 2010, 21（3）：137-141.
12. 　Sternik L, Luria D, Glikson M, et al. Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease. Ann Thorac Surg , 2010, 89（5）：1437-1442.
13. 　Okada M, Usui A, Sakurai T, et al. Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease. Kyobu Geka, 2010, 63（4）：297-302.
14. 　Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59（1）：17-29.
15. -592.
16. -841.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Outcomes of Maze Procedure Using Bipolar Radiofrequency Ablation for Surgical Treatment of Permanent Atrial Fibrillation

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