TITLE

Concomitant anti-arrhythmic procedures to treat permanent atrial fibrillation in CABG and AVR patients are as effective as in mitral valve patients

AUTHOR(S)

Khargi, Krishna; Lemke, Bernd; Deneke, Thomas

PUB. DATE

May 2005

SOURCE

European Journal of Cardio-Thoracic Surgery;May2005, Vol. 27 Issue 5, p841

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Abstract: Objective: Concomitant anti-arrhythmic procedures, to treat permanent atrial fibrillation, are not routinely performed in non-mitral valve surgery, such as coronary artery bypass grafting (CABG) and aortic valve (AVR) procedures. This study evaluated the sinus rhythm (SR) conversion rate of a concomitant anti-arrhythmia procedure in non-mitral valve surgery compared to mitral valve surgery. Methods: Between 1997 and 2003, 128 patients with a documented permanent atrial fibrillation had a concomitant anti-arrhythmic procedure using unipolar endocardial radiofrequency ablation; 65 mitral valve surgery (group I) and 63 aortic valve surgery or CABG (group II). Follow-up was complete and included standard ECG and echocardiogram at 3, 6, 12 months and each consecutive year. Stability of SR was confirmed with a 24-h ECG registration. Results: Type of procedures was MVR 42 (32.8%), MVP 23 (18.0%), CABG 40 (31.2), AVR 21 (16.4%), other 2 (1.6%). Thirty-day mortality for groups I and II were 4.6% (3/65) and 3.2% (2/63). Group II patients were distinctly older (69.3 versus 64.8 years; P=0.04), but the size of the left atrium was smaller (45.9 versus 52.4mm; P=0.0001) and the aortic cross-clamp time was shorter (91 versus 99min; P=0.05). The cumulative postoperative SR percentages for the groups I and II patients at 12 months were 71 versus 79%. A bi-atrial contraction was observed in 65.6% (21/32) and 68.3% (28/41) of the groups I and II patients, who had a stable SR. The mean (SD) follow-up for groups I and II was 24.4 (19.4) and 21.0 (17.2) months. The cumulative survival rate at 1, 2 and 3 years for groups I and II were 85 versus 88%, 83 versus 85%, 79 versus 85% (log-rank test P=0.60). Conclusion: A concomitant anti-arrhythmic procedure in CABG and AVR patients is as effective as in mitral valve patients, although these patients tend to be older, but with a smaller left atrial size.

ACCESSION #

17674403

 

Related Articles

• Cryoablation for surgical treatment of chronic atrial fibrillation combined with mitral valve surgery: a clinical observation. Ghavidel, Alireza Alizadeh; Javadpour, Hossein; Shafiee, Massoud; Tabatabaie, Mohammad-Bagher; Raiesi, Kamal; Hosseini, Saeed // European Journal of Cardio-Thoracic Surgery;Jun2008, Vol. 33 Issue 6, p1043 

  Abstract: Objective: Although the classical Cox-Maze III is the gold standard surgical therapy with a proven efficacy in the treatment of atrial fibrillation (AF), complexity of this procedure has resulted in a search for a simpler, less invasive and more cost-effective method. In this study we...

• Clinical, Echocardiographic, and Hemodynamic Characteristics of Rheumatic Mitral Valve Stenosis and Atrial Fibrillation. Kabukgu, Mehmet; Arslantas, Esin; Ates, Ismail; Demircioglu, Fatih; Ersel, Filiz // Angiology;Mar/Apr2005, Vol. 56 Issue 2, p159 

  Chronic atrial fibrillation (AF) is associated with an increased frequency of embolic events and negative impact on cardiac function, and therefore, an increased morbidity and mortality risk in patients with rheumatic mitral valve stenosis (RMS). In the present study, the clinical, 2-D and...

• Testing Of Box Lesion By Adenosine. kumar, Narendra; Pison, Laurent; la Meir, Mark; Crijns, Harry; Maessen, Jos // JAFIB: Journal of Atrial Fibrillation;Dec2013/Jan2014, Vol. 6 Issue 4, p95 

  A letter to the editor is presented in response to the article "Complete Isolation of the Left Atrial Posterior Wall (Box Lesion) to Treat Long Standing Persistent Atrial Fibrillation" by E. B. Saad and colleagues in the October 2013 issue.

• Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results. Akpinar, Belhhan; Guden, Mustafa; Sagbas, Ertan; Sanisoglu, Ilhan; Ozbek, Ugur; Caynak, Barıs; Bayindir, Osman // European Journal of Cardio-Thoracic Surgery;Aug2003, Vol. 24 Issue 2, p223 

  Objective: The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency (RF) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results. Material and method: During a 16 months time period, 67...

• Factors associated with the development of atrial fibrillation in patients with rheumatic mitral stenosis. Ozaydin, Mehmet; Turker, Yasin; Varol, Ercan; Alaca, Sule; Erdogan, Dogan; Yilmaz, Nigar; Dogan, Abdullah // International Journal of Cardiovascular Imaging;Jun2010, Vol. 26 Issue 5, p547 

  The aim of this study was to evaluate the factors associated with the development of atrial fibrillation (AF) in patients with rheumatic mitral stenosis (MS). A total of 146 consecutive patients with rheumatic MS were screened. They were accepted to be in AF group and sinus rhythm group...

• Predictive Factors of Sustained Sinus Rhythm and Recurrent Atrial Fibrillation after the Maze Procedure. Jong Bum Choi; Hyun Kyu Park; Kyung Hwa Kim; Min Ho Kim; Ja Hong Kuh; Mi-Kyung Lee; Sam Youn Lee // Korean Journal of Thoracic & Cardiovascular Surgery;2013, Vol. 46 Issue 2, p117 

  Background: We examined perioperative predictors of sustained sinus rhythm (SR) in patients undergoing the Cox maze operation and concomitant cardiac surgery for structural heart disease. Materials and Methods: From October 1999 to December 2008, 90 patients with atrial fibrillation (AF)...

• Multiple Levels of Conduction Block on Surface Electrocardiography in a Patient after Surgical Left Atrial Ablation of Atrial Fibrillation. Susi, Brian; Manetta, Frank; Scheinerman, S. Jacob; Slotwiner, David J.; Goldner, Bruce G.; Cheung, Jim W. // Texas Heart Institute Journal;2009, Vol. 36 Issue 1, p78 

  The article discusses multiple levels of conduction block on surface electrocardiography in a 75-year-old patient following surgical left atrial ablation of atrial fibrillation. Echocardiogram results of the patient show a normal left ventricular ejection fraction with myxomatous mitral valve...

• Comparative expression profiles of microRNA in left and right atrial appendages from patients with rheumatic mitral valve disease exhibiting sinus rhythm or atrial fibrillation. Hai Liu; Han Qin; Guang-xian Chen; Meng-ya Liang; Jian Rong; Jian-ping Yao; Zhong-kai Wu // Journal of Translational Medicine;2014, Vol. 12 Issue 1, p1 

  Background The atrial fibrillation (AF) associated microRNAs (miRNAs) were found in the right atrium (RA) and left atrium (LA) from patients with rheumatic mitral valve disease (RMVD). However, most studies only focus on the RA; and the potential differences of AF-associated miRNAs between the...

• Unique mitral valve mass: Think beyond vegetation. Farhoud, Mahmoud; Bakdash, Husam // Avicenna Journal of Medicine;Oct2014, Vol. 4 Issue 4, p102 

  Osteosarcoma is a rare cardiac malignant tumor. This case of cardiac osteosarcoma presented with atrial fibrillation. Initial echocardiogram demonstrated mitral valve echodensity and mitral valve regurgitation. Surgery and histopathological examination identified the tumor as an osteosarcoma....

Read the Article