Monopolar or Bipolar Radiofrequency Ablation for Atrial Fibrillation with Open Heart Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FUMing-pu ¹ ,  XUESong ² , HUANGRi-tai ²

1. Changle People's Hospital, Shandong province, Weifang 262400 Shandong, P. R. China;
2. Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, P. R. China;

Corresponding?author：

XUESong, Email: xuesong64@163.com

Keywords：

Radiofrequency ablation; Atrial fibrillation; Organic heart disease; Cardiac surgery

DOI：

10.7507/1007-4848.20150212

Video：

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Objective To evaluate the effect and experience of monopolar or bipolar radiofrequency ablation for organic heart disease with atrial fibrillation under the open heart surgery. Methods We retrospectively analyzed the clinical data of 305 patients with organic heart disease such as atrial fibrillation underwent the open heart surgery in Changle People's Hospital and Shanghai Renji Hospital between December 2004 year and December 2013 year. There were 188 male and 117 female patients at age of 38 to 81 years. The patients were divided into three groups according to monopolar or bipolar radiofrequency ablation used. There were 128 patients in a monopolar group, 165 patients in a bipolar group, and 12 patients in a combined group with monopolar radiofrequency ablation plus bipolar radiofrequency ablation. Result Two patients died after operation. There were 249 patients (81.6%) with sinus rhythm after operation. Sinus rhythm was restored 78.9% in the monopolar group compared with 83.6% in the bipolar group with a statistical difference (P>0.05). We followed up the patients for 3 to 85 (38.2±15.4) months after operation. There were no statistical differences in sinus rhythm rates after following-up 0.5 year (80.5% vs. 83.9%, P>0.05), 1 year (78.4% vs. 83.3%, P>0.05), 2 years (76.5% vs. 81.1%, P>0.05), and 5 years(73.8% vs. 77.1%, P>0.05). Conclusion Monopolar or bipolar radiofrequency ablation for atrial fibrillation with open heart surgery is an effective method, especially in long-term effect. There was no significant difference between the monopolar group and the bipolar group in effect. Bipolar radiofrequency ablation can reduce the ablation time.

Citation： FUMing-pu, XUESong, HUANGRi-tai. Monopolar or Bipolar Radiofrequency Ablation for Atrial Fibrillation with Open Heart Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(9): 851-854. doi: 10.7507/1007-4848.20150212 Copy

1.	Louagie Y, Buche M, Eucher JC, et al. Improved patient survival with concomitant cox maze Ⅲ procedure compared with heart surgery alone. Ann Thorac Surg, 2009, 87(2):440-446.
2.	曹煒, 石開虎, 徐盛松, 等. 心臟瓣膜置換加直視下雙極射頻消融治療持續性心房顫動. 中國醫藥, 2014, 9(7):957-959.
3.	Gillinov AM. Advances in surgical treatment of atrial fibrillation. Stroke, 2007, 38(2 Suppl):618-623.
4.	Beukema WP, Sie HT, Misier AR, et al. Intermediate to long term results of radiofrequency modified Maze procedure as an adjunct to open-heart surgery. Ann Thorac Surg, 2008, 86(5):1409-1414.
5.	Saint LL, Damiano RJ Jr. Surgical treatment of atrial fibrillation. Mo Med, 2012, 109:281-287.
6.	Gillinov AM, Sirak J, Blackstone EH, et al. The Cox maze procedure in mitral valve disease:predictors of recurrenl atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(6):1653-1660.
7.	Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59(1):17-29.
8.	Tomasz M, Maria S, Pawe? R, et al. Efficacy of intra-operative radiofrequency ablationin patients with permanent atrial fibrillation undergoing concomitant mitral valve replacement. Kardiol Pol, 2008, 66:932-938.
9.	汪曾煒, 劉維永, 張寶仁, 主編. 心臟外科學. 北京:人民軍醫出版社, 2003. 1691-1710.
10.	陳從濤, 曹海龍, 武忠, 等. 瓣膜病合并房顫外科射頻消融術后早期復發的危險因素分析. 實用醫學雜志, 2013, 29(10):1597-1599.
11.	楊嵩, 張希唐, 白云, 等. 永久性心房顫動外科雙極射頻消融術的效果. 中國胸心血管外科臨床雜志, 2012, 19(3):254-257.
12.	Sternik L, Luria D, Glikson M, et al. Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease. Ann Thorac Surg, 2010, 89(5):1437-1442.
13.	Tekumit H, Uzun K, Cenal AR, et al. Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation. Cardiovase J Afr, 2010, 21(3):137-141.
14.	Melo J, Santiago T, Aguiar C, et al. Surgery for atrial fibrillation in patients with mitral valve disease, results at five years from the International Registry of Atrial Fibrillation Surgery. J Thorac Cardiovasc Surg, 2008, 135(4):863-869.
15.	汪芳. 導管冷凍消融治療心房撲動和心房顫動. 中國臨床醫學, 2009, 16(1):10-11.
16.	方丕華, 侯煜. 冷凍消融治療心房顫動. 中國心血管雜志, 2009, 14(1):8-9.
17.	王輝山, 汪曾煒. 141例心臟手術同期施行雙極射頻迷宮手術治療心房顫動. 中華胸心血管外科雜志, 2009, 25(6):371-374.
18.	白景峰, 陳亞珠, 陳長治等. 射頻消融心臟房顫治療儀的研制.儀器儀表學報, 2006, 27(3):259-262.
19.	Muller P, Pasic M, Bergs P, et al. Introoperative high frequency current ablation as therapy of atrial fibrillation. Herz, 2002, 27(4):357-364.
20.	Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation:impact of the maze procedure. Circulation, 2012, 125(17):2071-2080.

1. Louagie Y, Buche M, Eucher JC, et al. Improved patient survival with concomitant cox maze Ⅲ procedure compared with heart surgery alone. Ann Thorac Surg, 2009, 87(2):440-446.
2. 曹煒, 石開虎, 徐盛松, 等. 心臟瓣膜置換加直視下雙極射頻消融治療持續性心房顫動. 中國醫藥, 2014, 9(7):957-959.
3. Gillinov AM. Advances in surgical treatment of atrial fibrillation. Stroke, 2007, 38(2 Suppl):618-623.
4. Beukema WP, Sie HT, Misier AR, et al. Intermediate to long term results of radiofrequency modified Maze procedure as an adjunct to open-heart surgery. Ann Thorac Surg, 2008, 86(5):1409-1414.
5. Saint LL, Damiano RJ Jr. Surgical treatment of atrial fibrillation. Mo Med, 2012, 109:281-287.
6. Gillinov AM, Sirak J, Blackstone EH, et al. The Cox maze procedure in mitral valve disease:predictors of recurrenl atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(6):1653-1660.
7. Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59(1):17-29.
8. Tomasz M, Maria S, Pawe? R, et al. Efficacy of intra-operative radiofrequency ablationin patients with permanent atrial fibrillation undergoing concomitant mitral valve replacement. Kardiol Pol, 2008, 66:932-938.
9. 汪曾煒, 劉維永, 張寶仁, 主編. 心臟外科學. 北京:人民軍醫出版社, 2003. 1691-1710.
10. 陳從濤, 曹海龍, 武忠, 等. 瓣膜病合并房顫外科射頻消融術后早期復發的危險因素分析. 實用醫學雜志, 2013, 29(10):1597-1599.
11. 楊嵩, 張希唐, 白云, 等. 永久性心房顫動外科雙極射頻消融術的效果. 中國胸心血管外科臨床雜志, 2012, 19(3):254-257.
12. Sternik L, Luria D, Glikson M, et al. Efficacy of surgical ablation of atrial fibrillation in patients with rheumatic heart disease. Ann Thorac Surg, 2010, 89(5):1437-1442.
13. Tekumit H, Uzun K, Cenal AR, et al. Midterm results of left atrial bipolar radiofrequency ablation combined with a mitral valve procedure in persistent atrial fibrillation. Cardiovase J Afr, 2010, 21(3):137-141.
14. Melo J, Santiago T, Aguiar C, et al. Surgery for atrial fibrillation in patients with mitral valve disease, results at five years from the International Registry of Atrial Fibrillation Surgery. J Thorac Cardiovasc Surg, 2008, 135(4):863-869.
15. 汪芳. 導管冷凍消融治療心房撲動和心房顫動. 中國臨床醫學, 2009, 16(1):10-11.
16. 方丕華, 侯煜. 冷凍消融治療心房顫動. 中國心血管雜志, 2009, 14(1):8-9.
17. 王輝山, 汪曾煒. 141例心臟手術同期施行雙極射頻迷宮手術治療心房顫動. 中華胸心血管外科雜志, 2009, 25(6):371-374.
18. 白景峰, 陳亞珠, 陳長治等. 射頻消融心臟房顫治療儀的研制.儀器儀表學報, 2006, 27(3):259-262.
19. Muller P, Pasic M, Bergs P, et al. Introoperative high frequency current ablation as therapy of atrial fibrillation. Herz, 2002, 27(4):357-364.
20. Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation:impact of the maze procedure. Circulation, 2012, 125(17):2071-2080.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Monopolar or Bipolar Radiofrequency Ablation for Atrial Fibrillation with Open Heart Surgery

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