Surgical Treatment of Chronic Atrial Fibrillation : Unipolar Radiofrequency Ablation versus Cryoablation, and Left Atrial versus Bi-atrial Maze Procedures

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著者

    • USUI Akihiko
    • Department of Cardio-thoracic Surgery, Nagoya University Graduate School of Medicine
    • UEDA Yuichi
    • Department of Cardio-thoracic Surgery, Nagoya University Graduate School of Medicine

抄録

This study evaluated the efficacy of the left atrial Maze procedure (Lt-maze) and unipolar radiofrequency (RF) ablation as an additional procedure for the surgical treatment of atrial fibrillation (AF) in patient with other cardiac disease.<BR>Methods and Results: The Maze procedure was performed in 100 consecutive patients with AF: Lt-maze, 71 patients; bi-atrial Maze (Bi-maze), 29 patients. Cryoablation and RF ablation were used in 82 and 18 patients, respectively. There were no in-hospital or early deaths. Fourteen patients (14%) experienced postoperative complications. Seventy-five patients (75%) were in sinus rhythm (SR) at discharge, 4 patients were in junctional rhythm, and 21 patients had AF. Two patients (2%) required permanent pacemaker implantation. The AF-free rate at discharge was 79%, and the AF-free rate at hospital discharge did not differ significantly between cryoablation and unipolar RF ablation (78% and 82%, respectively). There were no significant differences between these two groups in operative results, in terms of the aortic cross-clamp time, cardiopulmonary bypass time, and AF-free rate, with the AF-free rate not differing significantly in those who received single valve surgery (73% and 75% in the cryoablation and unipolar RF ablation groups, respectively). The equipment cost of the two procedures differed greatly: 14,000 yen/patient for cryoablation and 250,000 yen/patient for RF ablation. The AF-free rate did not differ significantly between Lt-maze (76%) and Bi-maze (86%), including in those who received single valve surgery (72% and 79%, respectively). The significant predictors of AF recurrence in a univariate analysis were left atrial diameter (p=0.03), duration of AF (p<0.01), fibrillation amplitude on ECG (p=0.02), and cardiothoracic ratio (p<0.01), with the duration of preoperative AF being the only significant predictor of AF in a multivariate analysis.<BR>Conclusion: In this series, unipolar RF ablation for the Maze procedure was as effective as cryoablation at eliminating AF, and Lt-maze and Bi-maze were equipotent at restoring SR at discharge.

収録刊行物

  • Journal of arrhythmia  

    Journal of arrhythmia 22(2), 103-109, 2006-08-25 

    Japanese Heart Rhythm Society

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各種コード

  • NII論文ID(NAID)
    10018040731
  • NII書誌ID(NCID)
    AA12059301
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    18804276
  • データ提供元
    CJP書誌  J-STAGE 
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