Efficacy comparison between video-assisted minimally invasive radiofrequency ablation and catheter ablation in the treatment of persistent atrial fibrillation
10.3760/cma.j.issn.0253-3758.2011.05.011
- VernacularTitle:胸腔镜辅助微创与导管射频消融治疗持续性心房颤动的对比研究
- Author:
Jian-Gang WANG
1
;
Xu MENG
;
Yan LI
;
Jie HAN
;
Chun-Lei XU
;
Yong-Qiang CUI
;
Jian-Zeng DONG
;
Chang-Sheng MA
Author Information
1. 首都医科大学附属北京安贞医院
- Keywords:
Atrial fibrillation;
Catheter ablation:Video-assisted
- From:
Chinese Journal of Cardiology
2011;39(5):429-433
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of the video-assisted minimally invasive radiofrequencv ablation in comparison with catheter ablation fbr the treatment of persistent atrial fibrillation (AF).Methods A total of 172 patients[116 male,mean age(56 ±12)years]with persistent AF underwent ablation procedures during the last 4 years in our institute(83 patients underwent video-assisted minimally invasive radiofrequeney ablation,group MIA and 89 patients underwent circumferential pulmonary vein linear ablation,group CA). Mean duration of preoperative AF was(72 ±68)months.Patients were follow-uped for a period of 1 to 3.6 years[mean(2.2±0.8)years].Results There was no procedure related death.During follow-up,one patient died of encephalorrhagia in CA group,one patient died of sudden death in each group. At the end of the procedure,there were 67 sinus rhythm(39.0%),4 pacing rhythm(2.3%),29 atrial flutter or atrial tachycardia(16.9%)and 72 AF(41.9%).Before discharge,sinus rhythm was recofded in 53 patients(63.9%)of MIA group and in 78 patients(87.6%)of CA group;AF recorded in 24 patients(28.9%)of MIA group and in 4 patients(4.5%)of CA group(P<0.01).At the latest follow-up,sinus rhythm was recorded in 65 patients(79.3%)of MIA group and in 54patients(62.1%)of CA group;AF or atrial flutter was recorded in 14 patients(17.1%)of MIA group and in 24 patients(27.6%)of CA group(P=0.028).The Kaplan-Meier survival analysis showed that the long-term efficacv of MIA is superior to CA in terms of incidence of free of AF, AF recurrence and antiarrhythmic drugs(P=0.03,P=0.028,P=0.017,respectively).Conclusions The video-assisted minimally invasive ablation was safe and effective,and had an optimistic long-term success rate for patients with long-lasting persistent AF.Thus,a randomized study comparing the long-term efficacy between the two procedures for patients with long-lasting persistent AF is warranted.
