Abstract 15503: Efficiency of Radiofrequency Ablation for Surgical Treatment of Chronic Atrial Fibrillation in Rheumatic Valvular Disease
Background: It remains unclear whether concomitant radiofrequency ablation procedure in valvular surgery could offer additional benefits in patients with rheumatic valvular disease. We designed a prospective and randomized control study (clinicaltrials.gov/ct2/show/ NCT01013688) to evaluate the efficacy of surgical radiofrequency ablation in patients with rheumatic heart disease.
Methods: From June 2008 to July 2010, 210 patients with chronic atrial fibrillation and rheumatic heart disease who need receive mitral valve replacement were randomized into three group: (1) control group, patients received only valve replacement followed by amiodarone rhythm control; (2) left atrial group, patients underwent valve replacement and left atrial mono-polar radiofrequency ablation, (3) Bi-atrial group, patients underwent valve replacement and bi-atrial mono-polar radiofrequency ablation. All patients fulfilled the follow-up at 3 months, 6 months and one year postoperatively.
Results: Preoperative characteristics were similar among three groups. There was no perioperative death. One patient died 4 months after MVR in Bi-atrial group. The Rate of sinus rhythm restoration at 6 months and 12 months postoperatively were 70.0% and 68.6% in LA group,70.0% and 70.1% in BA group,24.3% and 27.1% in amiodarone group (P<0.01). Atrial transport function restoration rate at 12 months postoperatively were 31.4% in LA group, 32.9% in BA group, 8.6% in amiodarone group respectively (P<0.01). And there was no significant difference between LA group and BA group in the form of sinus rhythm and atrial transport function restoration.
Conclusions: Radiofrequency ablation concurrently with valvular surgery could bring a higher sinus rhythm restoration rate when compare with medical anti-arrhythmic strategy in low risk rheumatic heart disease.
- © 2012 by American Heart Association, Inc.