Safety and efficacy of bipolar radiofrequency ablation combined with "cut-and-sew" technique for the mitral isthmus line in maze Ⅳ procedure
10.3760/cma.j.cn112434-20240105-00005
- VernacularTitle:迷宫Ⅳ型手术中对二尖瓣峡部线采取双极射频消融联合"切－缝"技术的安全性和疗效分析
- Author:
Ting ZHOU
1
;
Songlin ZHANG
Author Information
1. 三峡大学第一临床医学院，宜昌 443008
- Keywords:
Atrial fibrillation;
Maze Ⅳ procedure;
Mitral isthmus;
Peri-mitral atrial flutter;
Cut-and-sew technique
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(6):362-368
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To reduce peri-mitral atrial flutter/tachycardia(AFL/AT), this study modified the ablation method of the mitral isthmus(MI) by adopting bipolar radiofrequency ablation (RFA) combined with "cut-and-sew" technique.Methods:This was a clinical retrospective study, involving a total of 138 consecutive patients with AF who underwent a mitral valve surgery and concomitant maze Ⅳ procedure. According to methods of MI linear lesion, patients were divided into the modified group and the RFA group. The primary end points are maintenance of sinus rhythm (SR) rate and the incidence of AFL/AT.Results:During the perioperative period, one patient in the modified group died of suspected cardiogenic shock and septic shock. Follow up for two years, no deaths or stroke events occurred. The proportion of 6-, 12-, and 24-month maintenance of SR off class Ⅰ/Ⅲ antiarrhythmic drugs after surgery were 91.0%, 89.7%, and 88.5% in the modified group and 89.7%, 84.5%, and 81.0% in the RF group, respectively ( P>0.05). The incidence of postoperative AFL/AT was 5.1% in the modified group and 15.3% in the RF group ( P=0.044). The healthcare facility use expense in the RF group was 1.5 times that in the modified group. Early recurrence of AF was an independent risk factor for AF recurrence. Conclusion:In the mitral valve surgery and concomitant maze Ⅳ procedure, the modified method of bipolar RF ablation combined with "cut-and-sew" technique for the MI line is safe and feasible. Its incidence of postoperative AFL/AT is lower than that of the RF method, which reduces existing medical costs and could be accepted by more patients and regions.
