Canale Leonardo Secchin, Colafranceschi Alexandre Siciliano, Monteiro Andrey José Oliveira, Marques Bruno Miranda, Canale Clara Secchin, Koehler Ernesto Chavez, Cruz Filho Fernando Eugênio Dos Santos
Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brasil.
Rev Bras Cir Cardiovasc. 2011 Oct-Dec;26(4):565-72. doi: 10.5935/1678-9741.20110046.
To analyze the effectiveness of surgical treatment of atrial fibrillation (AF) using bipolar radiofrequency ablation during mitral valve procedures of rheumatic etiology in heart surgery.
We retrospectively reviewed medical registries of 53 patients submitted to atrial ablation with bipolar radiofrequency energy during mitral valve surgery. Thirty four (64%) patients were women and the age varied from 27 to 72 years old (average: 49.3 ± 10.7 years). Aortic and/or tricuspid procedures were also present in 36 (68%) patients. Average time of reported atrial fibrillation was 41 months (from 3 to 192 months). Type of AF was classified as: paroxysmal in 8 patients, persistent in 3, permanent in 42. Left atrium had an average size of 52.9 ± 8.5 mm. The surgeries in these series were: 47 mitral valve replacements and 6 mitral valve repairs. Electrocardiografic follow up was 83% complete in 14 months. Data from 24h Holter were explored.
Seven (13%) perioperative deaths were observed and survival after 14 months was 87%. Observed heart rhythm after 1 year of surgery was sinus rhythm in 25 (66%) patients, AF in 7 (18%), flutter in 7 (13%), junctional in 1 (3%).
Bipolar radiofrequency ablation in patients submitted to mitral valve surgery of rheumatic etiology is effective in converting to sinus rhythm in 68% of patients after 14 months.
分析在心脏外科风湿性病因二尖瓣手术中使用双极射频消融治疗心房颤动（AF）的有效性。
我们回顾性分析了53例在二尖瓣手术期间接受双极射频能量心房消融患者的医疗记录。其中34例（64%）为女性，年龄从27岁至72岁不等（平均：49.3±10.7岁）。36例（68%）患者还进行了主动脉和/或三尖瓣手术。报告的心房颤动平均时间为41个月（3至192个月）。房颤类型分类为：阵发性8例，持续性3例，永久性42例。左心房平均大小为52.9±8.5毫米。这些系列手术包括：47例二尖瓣置换术和6例二尖瓣修复术。14个月时心电图随访完成率为83%。分析了24小时动态心电图数据。
观察到7例（13%）围手术期死亡，14个月后的生存率为87%。术后1年观察到的心律情况为：窦性心律25例（66%），房颤7例（18%），房扑7例（13%），交界性心律1例（3%）。
在风湿性病因二尖瓣手术患者中，双极射频消融在14个月后可使68%的患者转为窦性心律，是有效的。
