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[二尖瓣疾病合并心房颤动外科治疗中冷冻消融与射频消融的对比研究]

[Comparative study between cryoablation and radiofrequency ablation for surgical intervention of atrial fibrillation associated with mitral valve disease].

作者信息

Okada Masaho, Usui Akihiko, Sakurai Takahisa, Terasawa Sachie, Tsunekawa Tomohiro, Eda Tadahito, Araki Yoshimori, Mizutani Shinichi, Narita Yuji, Oshima Hideki, Ueda Yuichi

机构信息

Department of Cardio-thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Kyobu Geka. 2010 Apr;63(4):297-302.

Abstract

OBJECTIVES

Recently, bipolar radiofrequency (RF) ablation has been introduced as a potential option to replace many of the Cox-maze incisions. We compared the surgical outcomes of maze procedures in patients who had undergone cryoablation and RF ablation and mitral valve surgery.

METHODS

From January 2004 to August 2009, a total of 40 patients underwent the maze procedure and concomitant mitral operation as a 1st operation. Of these, the cryoablation maze procedure (n = 20) and RF ablation procedure (n = 20) were performed in the patients with similar background, although more patients in the RF group had undergone mitral valve repair (n = 15) compared to the cryoablation group (n = 8) [p = 0.025].

RESULTS

The peri-operative data, such as operative duration, cardiopulmonary bypass time, aortic cross-clamp time, postoperative ventilation time, and the duration of intensive care unit (ICU) stay did not show any significant difference between cryoablation group and RF group. Both ablation procedures were similarly effective in restoring sinus rhythm at the early post-operative period (cryoablation: 80%, RF: 70%). Nine patients in the cryoablation group and 13 patients in the RF ablation group required anti-arrhythmic medication.

CONCLUSIONS

The RF ablation technique is simpler and equally effective in controlling atrial fibrillation compared to the cryoablation for the maze procedure of concomitant mitral valve surgery.

摘要

目的

最近,双极射频(RF)消融术已被引入,作为替代许多Cox迷宫切口的一种潜在选择。我们比较了接受冷冻消融、射频消融和二尖瓣手术患者的迷宫手术效果。

方法

从2004年1月至2009年8月,共有40例患者作为首次手术接受了迷宫手术及同期二尖瓣手术。其中,冷冻消融迷宫手术组(n = 20)和射频消融手术组(n = 20)的患者背景相似,尽管与冷冻消融组(n = 8)相比,射频组接受二尖瓣修复的患者更多(n = 15)[p = 0.025]。

结果

围手术期数据,如手术时间、体外循环时间、主动脉阻断时间、术后通气时间和重症监护病房(ICU)住院时间,在冷冻消融组和射频组之间没有显示出任何显著差异。两种消融手术在术后早期恢复窦性心律方面同样有效(冷冻消融:80%,射频:70%)。冷冻消融组有9例患者和射频消融组有13例患者需要抗心律失常药物治疗。

结论

与冷冻消融相比,射频消融技术在同期二尖瓣手术的迷宫手术中控制房颤方面更简单且同样有效。

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