Boulad Nour, Shammas Nicolas W, Early Gerald, Roberts Shauna, Shammas Gail A, Hu Yuhning Linda, Park Holly, Jerin Michael
Midwest Cardiovascular Research Foundation, Bettendorf, IA.
Cardiac and Thoracic Surgery, Pullman Hospital, Pullman, WA.
Ther Clin Risk Manag. 2017 Sep 19;13:1233-1237. doi: 10.2147/TCRM.S136173. eCollection 2017.
Intraoperative radiofrequency ablation (RFA) has been advocated to treat atrial fibrillation (AF). This report examines the long-term effects of intraoperative RFA in the prevention of recurrence of AF when used as an adjunctive treatment in patients undergoing cardiac procedures for primary indications unrelated to their arrhythmia.
The study reviewed the records of patients from a tertiary medical center which had 2 cardiac surgeons performing an intraoperative adjunctive RFA procedure. A total of 20 patients undergoing RFA between April 11, 2003 and May 10, 2005 were included and followed for up to 10 years. The primary effectiveness outcome of the study was the recurrence of AF during the follow-up period. Data were collected from office or hospital medical records.
A total of 20 patients were included (mean age 69.4 years, males 40%). Eight patients were followed for 10 years and 2 patients for 9 years; 7 patients died during the 10-year follow-up period and 3 patients were lost to follow-up. As their primary procedures, the patients underwent valve surgery (65%), bypass surgery (15%), or both (20%). Intraoperative RFA failed to restore sinus rhythm in 2 patients. In the remaining 18 patients, AF recurred in 10 patients within 2 months of surgery, in 1 patient at 5 months, in 1 patient at 7 months, and in 6 patients after 1 year.
AF had recurred in 100% of patients by the end of the long-term follow-up period. The adjunctive intraoperative RFA and postoperative interventions employed in this early study failed to maintain sinus rhythm.
术中射频消融术（RFA）已被提倡用于治疗心房颤动（AF）。本报告探讨了术中RFA作为辅助治疗应用于因原发性适应证（与心律失常无关）接受心脏手术的患者时，在预防AF复发方面的长期效果。
该研究回顾了一家三级医疗中心的患者记录，该中心有2名心脏外科医生进行术中辅助RFA手术。纳入了2003年4月11日至2005年5月10日期间接受RFA的20例患者，并进行了长达10年的随访。该研究的主要有效性结局是随访期间AF的复发情况。数据从门诊或医院病历中收集。
共纳入20例患者（平均年龄69.4岁，男性占40%）。8例患者随访了10年，2例患者随访了9年；7例患者在10年随访期间死亡，3例患者失访。作为主要手术，患者接受了瓣膜手术（65%）、搭桥手术（15%）或两者皆有（20%）。术中RFA未能使2例患者恢复窦性心律。在其余18例患者中，10例患者在术后2个月内AF复发，1例患者在5个月时复发，1例患者在7个月时复发，6例患者在1年后复发。
在长期随访期结束时，100%的患者AF复发。这项早期研究中采用的术中辅助RFA及术后干预未能维持窦性心律。
