Jiang Bo, Gu Ji-Wei, Song Yan-Yan, Bai Lei, Liu Xu-Dong, Zhang Yu-Jing, Li Ming-Liang, Yang Jian, Liu Li, Wang Yun
Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, People's Republic of China.
Int J Gen Med. 2021 May 26;14:1547-1553. doi: 10.2147/IJGM.S302209. eCollection 2021.
To investigate the therapeutic effects of a modified simultaneous unipolar saline-irrigated radiofrequency ablation by intracardiac operation under direct vision in patients with mitral valve diseases combined with atrial fibrillation (AF).
A total of 168 patients with mitral valve diseases combined with AF who underwent unipolar saline-irrigated radiofrequency ablation modified maze procedures were enrolled and divided into the mitral stenosis (MS) group (n = 87) and the mitral insufficiency (MI) group (n = 81).
Those with a left atrium diameter (LAD) < 55 mm had a better cardioversion effect during the mid-term post-operation than those with a LAD ≥ 55 mm (P < 0.05). The cardioversion effect during the mid-term post-operation was better in those with a duration of AF < 2 years than those with AF ≥ 2 years (P < 0.05). The LAD reduced significantly during the early postoperative period in the MS group (P < 0.05). Compared with the early postoperative period, LAD further reduced, and the EF increased significantly during the mid-term post-operation (P<0.05). The LAD reduced significantly during the early postoperative period in the MI group (P < 0.05), together with relatively decreased EF (P < 0.05). Compared with the early postoperative period, LAD further reduced, and the EF increased significantly during the mid-term post-operation (P<0.05). The improvement of LAD in the MI group during the mid-term post-operation was better than that in the MS group (P < 0.05).
The cardioversion effects and the improvement in cardiac function during the mid-term post-operation were good in the radiofrequency ablation by intracardiac operation under direct vision in patients with different mitral valve diseases combined with AF. The cardioversion effects during the early postoperative period and the mid-term post-operation were better in patients with MI than in those with MS.
探讨直视下心内手术改良单极盐水灌注射频消融治疗二尖瓣疾病合并心房颤动（房颤）患者的疗效。
选取168例行改良迷宫手术单极盐水灌注射频消融治疗的二尖瓣疾病合并房颤患者，分为二尖瓣狭窄（MS）组（n = 87）和二尖瓣关闭不全（MI）组（n = 81）。
左心房直径（LAD）< 55 mm者术后中期的复律效果优于LAD≥55 mm者（P < 0.05）。房颤病程< 2年者术后中期的复律效果优于房颤病程≥2年者（P < 0.05）。MS组术后早期LAD显著降低（P < 0.05）。与术后早期相比，术后中期LAD进一步降低，左心室射血分数（EF）显著升高（P<0.05）。MI组术后早期LAD显著降低（P < 0.05），EF相对降低（P < 0.05）。与术后早期相比，术后中期LAD进一步降低，EF显著升高（P<0.05）。MI组术后中期LAD的改善情况优于MS组（P < 0.05）。
直视下心内手术射频消融治疗不同二尖瓣疾病合并房颤患者，术后中期复律效果及心功能改善良好。MI患者术后早期及中期的复律效果优于MS患者。
