The midterm results of total Maze radiofrequency ablation procedure with vagal denervation in treatment of atrial fibrillation accompanied rheumatic heart valve disease
10.3760/cma.j.issn.1001-4497.2017.03.015
- VernacularTitle:去自主神经化全迷宫外科消融术治疗风湿性心脏瓣膜病伴发持续性房颤中期随访
- Author:
Zongtao YIN
;
Huishan WANG
;
Zengwei WANG
;
Yong ZHANG
;
Jinsong HAN
;
Yu LIU
;
Hongguang HAN
- Keywords:
Atrial fibrillation;
Catheter ablation;
Autonomic denervation
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2017;33(3):179-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the radiofrequency ablation (RA) and vagal denervafion (VD) in surgical treatment of long-standing atrial fibrillation (AF) associated with rheumatic heart disease (RHD).Methods Retrospective analysis the cardiac rhythm by 24-hour Holter monitoring during 5-year follow-up after total Maze procedure accompanied rheumatic mitral valve replacement.Between June 2006 and December 2007,a total of 173 consecutive patients with long-standing AF-associated RHD underwent mitral valve replacement and ablation maze procedure,92 cases had RA alone and 81 had RA + VD.Results Although Kaplan-Meier curve shows that the freedom from AF at 5 years follow-up time were similar(P =0.718),the percentage of antiarrhythmic drug therapy was significant higher in the RA group during early postoperative period(4th month,54.1％ vs.34.7％,P=0.017;5th month,39.2％ vs.21.3％,P=0.018;6th month,23.0％ vs.10.7％,P =0.044),and the percentage of those free by AF was significant lower(6th month,82.2％ vs.93.8％,P =0.023;1st year,76.1％ vs.89.9％,P=0.019).Conclusion Total maze procedure with bipolar radiofrequency ablation is effective to treat longstanding AF associated with rheumatic valve disease.Vagal denervation helped to maintain stable sinus rhythm and lower antiarrhythmic drug therapy at the early stage,but there was no additional benefit after the 1 st year of follow-up,it may be caused from the reactivation of vagal plexus electrical activity.
