Long-term results of simultaneous hybrid ablation of therapy-resistant atrial fibrillation

Abstract Background A hybrid technique using thoracoscopic epicardial and standard endocardial ablation of atrial fibrillation (AF) is a strategy used to treat AF patients with therapy-resistant symptomatic AF. We conducted comparative study of efficacy and safety of simultaneous hybrid ablation in patients with non-paroxysmal forms of AF and evaluated the factors that determine success and quality of life. Methods The study included 56 consecutive patients who underwent simultaneous hybrid ablation. First, epicardial ablation was performed using thoracoscopic access: to isolate the pulmonary veins and the posterior wall of the left atrium. After this, an endocardial electrophysiological assessment was carried out from the pulmonary veins to the left atrium and additional endocardial ablation was performed, where necessary. The next day, a loop ECG recorder was implanted subcutaneously in the thoracic region. Efficiency was evaluated using implanted loop ECG recorders. The average follow up was 24 months, the studied patients came to the clinic every 3 months to receive diagnostic reports from loop recorders. Recurrence was defined as AF, atrial flutter and other atrial tachycardia, recorded in reports of loop recorders lasting >30 sec during follow up period. Results Continuous follow up was carried out in 56 patients, the average age of which was 57±9 years. Of these, 39 (70%) men, 6 (10%) paroxysmal, 38 (68%) persistent and 12 (22%) long-standing persistent AF. Within 24 months of follow up, 45 (80%) maintened a sinus rhythm. Most recurrenses were atrial flutter (8/11 patients). Success was associated with factors such as left atrial size, patient age and duration of arrhythmia. Patients with paroxysmal AF had the highest success, patients with long-standing persistent AF had the least success. 5 (9%) patients had complications associated with the procedure. Quality of life after ablation improved in patients with sinus rhythm. Conclusion The efficiency of simultaneuous hybrid AF ablation was 80% for 24 months of continuous follow up period associated with the type of AF. Quality of life improved significantly, complications associated with the procedure occurred in 9%. Funding Acknowledgement Type of funding source: None

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Quality of life and occurrence of atrial fibrillation in long-term follow-up of common type atrial flutter ablation:

Clinical Research in Cardiology ◽

10.1007/s00392-007-0559-z ◽

2007 ◽

Vol 96 (11) ◽

pp. 794-802 ◽

Cited By ~ 7

Author(s):

Axel Meissner ◽

Martin Christ ◽

Petra Maagh ◽

Rolf Borchard ◽

Marc van Bracht ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Atrial Flutter ◽

Common Type ◽

Long Term Follow Up ◽

Atrial Flutter Ablation

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P1407Efficacy of radiofrequency ablation of paroxysmal and persistent atrial fibrillation in heart failure patients

EP Europace ◽

10.1093/europace/euaa162.309 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

S Seliutskii ◽

N Savina ◽

A Chapurnykh

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Left Atrium ◽

Sf 36 ◽

Group 2 ◽

Group 1

Abstract Background radiofrequency ablation (RFA) is considered to be one of the most preferred treatments for atrial fibrillation (AFib) in patients with heart failure (HF). Objective to study the effectiveness of AFib RFA in patients with HF, to compare the effectiveness of the procedure in patients with paroxysmal (PaAFib) and persistent (PeAFib) AFib. Materials and methods 65 patients with AF and HF with LVEF < 50%, who underwent RFA were included in a prospective study. All patients underwent transthoracic echocardiography and quality of life assessment using the SF-36 questionnaire before RFA and after 12 months. AFib was recorded in 42 (65%) of patients, AFL in 23 (35%). Thirty (46%) patients had PaAfib (Group 1), and 35 (54%) PeAFib (Group 2). Results In 45 (69%) patients sinus rhythm (SR) was restored during RFA, in 15 (23%) SR was restored by electrical cardioversion. In 5 (8%) patients with PaAFib revealed SR at the time of RFA. Twelve month follow-up period revealed 49 (75%) patients who were free from AFib: 23 (77%) patients with PaAFib and 26 (74%) with PeAFib. After 12 month follow-up we revealed the improvement in LVEF (p < 0.001 in both groups), decrease of anteroposterior size of left atrium (LA) (p < 0.001 in both groups) and LA volume (p < 0.001 in both groups), improvement in the mental (p = 0.008 in Group 1; p = 0.006 in Group 2) and physical component of health according to the SF-36 questionnaire (p = 0.036 in Group 1; p = 0.049 in Group 2). There were no significant differences between two groups of follow-up period. Conclusions AFib RFA significantly improves the course of heart failure and the quality of life of patients, leads to decrease of left atrium size and increase of LVEF. The effectiveness of RFA does not depend on the type of arrhythmia in HF patients.

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Short- and mid-term results of thoracoscopic atrial fibrillation ablation

Complex Issues of Cardiovascular Diseases ◽

10.17802/2306-1278-2019-8-4s-82-8 ◽

2020 ◽

Vol 8 (4S) ◽

pp. 82-88

Author(s):

E. A. Khomenko ◽

S. E. Mamchur ◽

K. A. Kozyrin ◽

R. S. Tarasov ◽

K. V. Bakovsky

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Catheter Ablation ◽

Sinus Rhythm ◽

Left Atrium ◽

Atrial Flutter ◽

Left Atrial ◽

Left Atrial Appendage ◽

Pulmonary Veins ◽

One Year

Aim. Evaluation of short- and mid-term (up to one year) results of aт atrial fibrillation thoracoscopic radiofrequency ablation (TRFA) combined with left atrial appendage resection.Methods. 10 patients with persistent AF were included in the study. In 5 cases surgical ablation was performed as the primary intervention and in 5 cases surgery were preceded by two unsuccessful catheter procedures. Age of the patients was 54.4 (41; 63) years, duration of arrhythmic anamnesis – 5.6 (4.8; 6.8) years, anteroposterior size of the left atrium – 4.7 (45; 51 mm), LV ejection fraction – 63 (58; 68) %. TRFA included an isolation of right and left pulmonary veins, ablation lines along the roof and base of posterior wall of the left atrium, left atrial appendage resection.Results. In all cases of TRFA exit-block from the pulmonary veins was achieved. Among 10 procedures, a stable sinus rhythm was documented in 6 patients. In the remaining 4 patients AF was observed only in one case, and the other three demonstrated atypical atrial flutter, that given us a reason to repeat catheter procedures. In three cases of left atrial flutter, catheter ablation led to sinus rhythm restoration, and in case of AF and total sclerosis of left atrium a decision to refuse RF ablation was made. Complications were presented by a single case of bilateral phrenic nerve palsy, which required plication of the diaphragm, and two spontaneously resolved pulmonary atelectasis.Conclusion. The efficacy of atrial fibrillation thoracoscopic radiofrequency ablation during the follow-up period of one year was 90% regarding selective hybrid approach (thoracoscopic + catheter procedure). Procedure safety of TRFA was much lower than that of catheter ablation: the total number of small and big complications was 30%.

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Abstract 4649: A Radiofrequency HOT Balloon Catheter for Isolating the Posterior Left Atrium Including All the Pulmonary Veins in the Treatment of Atrial Fibrillation: Feasibility and Safety of a New Approach

Circulation ◽

10.1161/circ.118.suppl_18.s_924-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Hiroshi Sohara ◽

Shutaro Satake ◽

Hiroshi Takeda ◽

Hideki Ueno ◽

Toshimichi Oda

Keyword(s):

Atrial Fibrillation ◽

Left Atrium ◽

Phrenic Nerve ◽

Pulmonary Veins ◽

Balloon Catheter ◽

Holter Monitoring ◽

Phrenic Nerve Palsy ◽

Total Procedure Time ◽

Successful Isolation

Atrial fibrillation (AF) is originated from mostly from pulmonary vein (PV) foci or non-PV foci in the posterior left atrium (PLA). The present study was designed to evaluate the usefulness of a radiofrequency HOT balloon catheter (RBC) for isolation of the PLA including all PVs en masse in the patients with AF. In a total of 96 patients (75 men and 21 women; mean age 64±8 years old) with drug-resistant paroxysmal (n=63) and persistent AF(n=33), PLA including all PVs were ablated and isolated using RBC. Dragging the balloon, contiguous lesions at the roof between the superior PVs were first created, then each antrum of all PVs were ablated, and finally, contiguous lesions at the PLA between the both inferior PVs were made, while we performed monitoring esophagus temperature and phrenic nerve pacing. Electro-anatomical bipolar voltage amplitude mapping (CARTO) of the LA-PVs was performed to determine the extent of this electrical isolation after all procedure. Successful isolation of the PLA including all PVs was achieved in all of 96 cases with elimination of all the PLA and PV potentials. The mean total procedure time 133 ± 31 minutes including 32±9 minutes fluoroscopy time. Recurrences of AF were diagnosed by Holter monitoring, mobile electrocardiogram. After first session, eighty- seven (59 paroxysmal, 28 persistent) of 96 patients were free from AF without anti-arrhythmic drugs and the remaining patients could maintain sinus rhythm with anti-arrhythmic drugs except two cases with LA flutter during 11.0±4.1 months follow-up. No major complications such as cerebral embolism, PV stenosis, or phrenic nerve palsy, and LA-esophageal fistula were observed. Complete isolation of the PLA including all PVs using a RBC, is useful for the treatment of both paroxysmal and persistent AF without severe complication.

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P60 Poster Profile and quality of life of patients with atrial fibrillation treated with pulmonary veins ablation

European Journal of Cardiovascular Nursing ◽

10.1016/s1474-51511160042-x ◽

2011 ◽

Vol 10 (1_suppl) ◽

pp. 9-10

Author(s):

A.-L. Fernandez-Oliver ◽

A.-R. Davila-Berrocal ◽

J. Burgos-Mora ◽

C. Galacho-Ramirez ◽

M.-J. Sanchez-Fernandez ◽

...

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Pulmonary Veins

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Comparison of modified MAZE with minimally invasive monopolar ablation and traditional bipolar radiofrequency ablation in the treatment of atrial fibrillation

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-019-1012-x ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Wei Si ◽

Sijia Yang ◽

Linhui Pan ◽

Chengchegn Li ◽

Liang Ma

Keyword(s):

Quality Of Life ◽

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Minimally Invasive ◽

Sinus Rhythm ◽

Ablation Rate ◽

Atrial Fibrillation Ablation ◽

Bipolar Radiofrequency ◽

Postoperative Quality

Abstract Background and aim of the study Atrial fibrillation (AF) is the most common atrial arrhythmia. Our aim was to compare the outcomes of atrial fibrillation treatment with original modified minimally invasive MAZE using monopolar radiofrequency ablation (mi-MAZE) and open surgery MAZE using bipolar radiofrequency ablation (os-MAZE). Methods We searched the associated patients’ information on the medical record system of the First Affiliated Hospital, School of Medicine, Zhejiang University. Statistical Package for Social Sciences (SPSS) was used to analyse the data. The primary outcome is the atrial fibrillation ablation rate 3 months, 6 months, 12 months after operation. And secondary outcome is the postoperative quality of life. Results The mi-MAZE group included 42 patients and the os-MAZE group had 65 patients. Three months after surgery, we found that 31 patients (77.5%) in the mi-MAZE group were sinus rhythm and 44 (71.0%) recovered sinus rhythm in the os-MAZE group. We followed up these patients on the phone or in person and scored them on the SF-36 scale. The results were found to be 120.2 ± 8.10 vs 110.6 ± 6.58 (mi-MAZE vs os-MAZE, P < 0.001). Conclusions There was no significant difference of atrial fibrillation ablation rate (sinus rhythm recovery rate) between the mi-MAZE group and the os-MAZE group. The postoperative quality of life in mi-MAZE group was higher than that in os-MAZE group.

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Surgical management of recurrent disc herniations with microdiscectomy and long-term results on life quality: Detailed analysis of 70 cases

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.165426 ◽

2016 ◽

Vol 7 (01) ◽

pp. 87-90 ◽

Cited By ~ 3

Author(s):

Serdal Albayrak ◽

Sait Ozturk ◽

Emre Durdag ◽

Ömer Ayden

Keyword(s):

Quality Of Life ◽

Facet Joint ◽

Lumbar Disc ◽

Life Quality ◽

Early Period ◽

Long Term Results ◽

Disc Herniations

ABSTRACT Background: Aim of this paper is to recall the surgical technique used in the recurrent lumbar disc herniations (LDHs) and to share our experiences. Materials and Methods: Out of series of 1115 patients who underwent operations for LDH between 2006 and 2013, 70 patients underwent re-operations, which were included in this study. During surgery, lateral decompression performed over the medial facet joint to the superior facet joint border was seen after widening the laminectomy defect, and microdiscectomy was performed. The demographic findings of the patients, their complaints in admission to hospital, the level of operation, the condition of dural injury, the first admission in the prospective analysis, and their quality of life were evaluated through the Oswestry scoring during their postoperative 1st, 3rd, 6th-month and 1st, 3rd, 5th and 7th-year follow-up. In the statical analysis, Friedman test was performed for the comparison of the Oswestry scores and Siegel Castellan test was used for the paired nonparametrical data. A P < 0.05 was considered statistically significant. Results: Considering the Oswestry Index during the follow-ups, the values in the postoperative early period and follow-ups were seen to be significantly lower than those at the time of admission to hospital (P < 0.05). None of the patients, who re-operated by microdiscectomy, presented with iatrogenic instability in 7 years follow-up period. Conclusion: Microdiscectomy performed through a proper technique in the re-operation of recurrent disc herniations eases complaints and improves the quality of life. Long-term follow-ups are required for more accurate results.

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