Department of Cardiology, Provincial Hospital, Szczecin, Poland.
Cardiol J. 2013;20(5):499-505. doi: 10.5603/CJ.2013.0135.
Occurrence of symptomatic, paroxysmal or persistent atrial fibrillation (AF) prior to admission to hospital for the purposes of cardiac surgery constitutes an indication forconsideration of simultaneous surgical radiofrequency (RF) ablation of such tachyarrhythmia. The aim of this study was to evaluate the efficacy of surgical RF ablation in the treatment of AF with the application of ECG teletransmission in monitoring patients during a 6-month follow-up period. Furthermore, clinical and echocardiographic risk factors for arrhythmia recurrences were subject to analysis. As per authors' knowledge and literature review, so far no papers devoted to the assessment of efficacy of surgical RF ablation with the use of systematic ECG teletransmission have been published.
The study enrolled 61 patients (20 females) suffering from AF who underwent cardiac surgeries and were additionally subject to surgical RF ablation. The mean age of the subjects was 64 ± 9 years. Efficacy of the procedure was monitored with the application of a system enabling transtelephonic transmission of ECG signal. The study cohort was monitored in the period of 6 months. 2198 ECG recordings were obtained for analysis.
In the post-hospital follow-up period, no recurrences of AF were observed in the case of 40 (65%) subjects. Post-hospital failure of the surgical RF ablation procedure was associated with an early episode of AF during hospitalization (p = 0.0012), application of monopolar electrode (p = 0.0325) as well as with the surgical procedure performed to treat mitral stenosis (p = 0.0268).
Moreover, it was observed that the group of patients without arrhythmia recurrence in the follow-up period was more frequently administered with antiarrhythmic medications (p = 0.0409) and statin (p = 0.0453) prior to the ablation procedure, with statin being more often applied after the procedure (tendency, p = 0.0747). As opposed to ablation in one atrium, biatrial ablation did not result in fewer late arrhythmia recurrences.
在因心脏手术而入院之前，出现有症状、阵发性或持续性心房颤动（AF）的情况构成了考虑同时进行此类快速性心律失常的手术射频（RF）消融的指征。本研究的目的是评估在 6 个月的随访期间应用心电图远程传输监测患者的情况下，手术 RF 消融治疗 AF 的疗效。此外，还分析了心律失常复发的临床和超声心动图危险因素。据作者所知并通过文献回顾，迄今为止，尚未有专门评估使用系统心电图远程传输的手术 RF 消融疗效的论文发表。
该研究纳入了 61 名（20 名女性）患有 AF 的患者，他们接受了心脏手术，并另外接受了手术 RF 消融。患者的平均年龄为 64 ± 9 岁。通过应用允许心电图信号远程传输的系统来监测该程序的疗效。该研究队列在 6 个月的期间内进行监测。共获得 2198 份心电图记录进行分析。
在出院后的随访期间，40 名（65%）患者中未观察到 AF 复发。手术后 RF 消融失败与住院期间早期发生 AF（p = 0.0012）、应用单极电极（p = 0.0325）以及治疗二尖瓣狭窄的手术程序（p = 0.0268）有关。
此外，还观察到在随访期间没有心律失常复发的患者组在消融前更频繁地接受抗心律失常药物（p = 0.0409）和他汀类药物（p = 0.0453）治疗，并且在消融后更频繁地应用他汀类药物（趋势，p = 0.0747）。与单心房消融相比，双心房消融并未导致晚期心律失常复发减少。
