Acute Effects of Left Atrial Radiofrequency Ablation on Atrial Fibrillation

Objective To investigate the safety of radiofrequency ablation for reducing inflammatory cytokines and the left atrial diameter in patients with atrial fibrillation (AF). Methods A total of 200 patients with AF who were admitted to our hospital from December 2015 to April 2017 were included in this prospective analysis. Fifty patients were treated with conventional AF medication alone (AF medication group) and 50 patients received radiofrequency ablation (RFA) on the basis of conventional medication (RFA group). Results After treatment, the AF medication group showed significantly higher levels of high-sensitivity C-reactive protein, interleukin-6, carboxyterminal propeptide of type-I procollagen, procollagen type III N-terminal propeptide, and matrix metallopeptidase-9 than the RFA group. The AF medication group had a significantly lower activated partial thromboplastin time, thrombin time, and prothrombin time than the RFA group. A significantly smaller left atrial diameter was observed in both groups after treatment, but this decrease was more pronounced in the RFA group than in the AF medication group. The total treatment efficacy rate was significantly lower in the AF medication group than in the RFA group. Conclusions For patients with AF, RFA leads to a lower incidence of inflammatory responses, faster recovery of cardiac function, and good safety.

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Thickening of the Left Atrial Wall Shortly After Radiofrequency Ablation Predicts Early Recurrence of Atrial Fibrillation

Circulation Journal ◽

10.1253/circj.cj-10-0026 ◽

2010 ◽

Vol 74 (8) ◽

pp. 1538-1546 ◽

Cited By ~ 15

Author(s):

Miki Yokokawa ◽

Hiroshi Tada ◽

Keiko Koyama ◽

Toshihiko Ino ◽

Shigeto Naito ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Left Atrial ◽

Early Recurrence ◽

Atrial Wall ◽

Left Atrial Wall

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Transesophageal Echocardiographic Assessment of Left Atrial and Left Atrial Appendage Function after Radiofrequency Ablation of Atrial Fibrillation

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2005.06.211 ◽

2005 ◽

Vol 11 (6) ◽

pp. S146

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Echocardiographic Assessment

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Recovery of left atrial function following pulmonary vein isolation using radiofrequency ablation in chronic atrial fibrillation: An intracardiac doppler echocardiographic study

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)81368-2 ◽

2003 ◽

Vol 41 (6) ◽

pp. 448-449 ◽

Cited By ~ 1

Author(s):

Erwan Donal ◽

Richard A. Grimm ◽

Hirotsugu Yamada ◽

Yong Jin Kim ◽

Nassir Marrouche ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Left Atrial ◽

Chronic Atrial Fibrillation ◽

Atrial Function ◽

Left Atrial Function ◽

Echocardiographic Study

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Left Atrial Appendage Exclusion in Atrial Fibrillation Radiofrequency Ablation during Mitral Valve Surgery: A Single-Center Experience

Cardiology Research and Practice ◽

10.1155/2021/9999412 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

C. Lavalle ◽

M. Straito ◽

E. Chourda ◽

S. Poggi ◽

G. Frati ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Left Atrial ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Maze Procedure ◽

Circumflex Artery ◽

Left Circumflex Artery

Background. Atrial fibrillation surgical radiofrequency ablation (AFSA) during mitral valve surgery (MVS) has almost completely superseded the Cox-Maze procedure for the treatment of atrial fibrillation. Methods. We retrospectively analyzed 100 patients who underwent MVS + AFSA in our institution from January 2008 to June 2017. We compared the effectiveness of AFSA in patients who underwent LAA exclusion to those who did not. Moreover, we analyzed the role of preoperative AF duration (≤ or >1 year) and medial-lateral left atrial dimensions (ML-LAD) (≤ or >6 cm). The efficacy endpoint was freedom from AF at discharge and at 2-year follow-up. The safety endpoints were need of a permanent pacemaker (PMK), surgical re-exploration, occurrence of stroke, and left circumflex artery or esophageal lesions. Results. Overall, the rate of AF freedom was 69% at discharge and 80% at 2-year follow-up. LAA exclusion did not influence AF freedom at 2-year follow-up, and 84.6% of patients who underwent LAA exclusion were in the sinus rythm (SR) at 2 year compared to 75% of those who did not receive LAA exclusion free from AF as well ( p = 0.230 ). AF duration ≤1 or >1 year did not influence sinus rhythm (SR) maintenance (85.7% vs. 75.8%; p = 0.224 ), and in these two groups, LAA exclusion did not change the efficacy of AFSA. ML-LAD ≤ 6 cm was associated with better results in terms of SR maintenance. A statistically significant association between LAA exclusion and SR maintenance at 2-year follow-up ( p = 0.017 ) was found among patients with ML-LAD ≤ 6 cm. Complications included 7 cases of PMK implantation, 2 cases of surgical re-exploration, and 1 case of stroke. No circumflex artery or esophageal lesions occurred after surgical procedures. Conclusions. In our experience, AFSA during isolated MVS resulted in good outcomes in terms of SR maintenance and incidence of complications. AF duration ≤ 1 year did not influence results, while patients with ML-LAD ≤ 6 cm had significantly better results regarding SR at follow-up. In patients with ML-LAD ≤ 6 cm, LAA exclusion significantly increased the success rate of SR maintenance at 2-year follow-up.

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Predictors of Failure Cardioversion for Recurrent Atrial Fibrillation Following Mitral Valve Surgery With Ablation

The Heart Surgery Forum ◽

10.1532/hsf.2997 ◽

2020 ◽

Vol 23 (3) ◽

pp. E300-E304

Author(s):

Hailong Cao ◽

Xin Chen ◽

Xiyu Zhu ◽

Yining Yang ◽

Qing Zhou ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Mitral Valve ◽

Atrial Flutter ◽

Left Atrial ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Loading Dose ◽

Left Atrial Diameter ◽

Recurrent Atrial Fibrillation

Background: Electrical cardioversion (ECV) often is required for terminating recurrent atrial fibrillation (AF) after surgical radiofrequency ablation in patients undergoing mitral valve surgery. However, ECV is unsuccessful in some cases. In this study, we aimed to identify possible predictors of failed ECV for recurrent atrial fibrillation following mitral valve surgery with concomitant radiofrequency ablation. Methods: We enrolled 1,136 persistent AF patients with history of mitral valve surgery and concomitant radiofrequency ablation. Three-hundred-nineteen patients experienced recurrence of persistent AF and received ECV therapy. Comparison was made between patients with failed ECV (Failure group, N = 68) and successful ECV (Success group, N = 251). Results: In multivariate regression analysis, age, pre-ECV loading-dose amiodarone, left atrial diameter, atrial flutter and time from surgery to ECV were independent predictors for outcomes of ECV. According to receiver operating characteristic curve analysis, the best threshold values of age, left atrial diameter and time from surgery to ECV for predicting failed ECV were 55.5 years, 64.5 mm, and 90.5 days, respectively. Conclusion: Older age, larger left atrium and longer time from surgery to ECV are independent predictors for failed ECV in this group. Compared with AF, atrial flutter is easier to be successfully terminated by ECV. Pre-ECV loading-dose amiodarone is helpful for successful ECV. These findings have important implications for identifying the kinds of patients to receive effective ECV.

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