scholarly journals Clinical Study on Long-Term Sinus Reversion Rate and Left Atrial Function Recovery of Mitral Valve Disease with Atrial Fibrillation under Modified Surgical Radiofrequency Ablation

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jingle Cui ◽  
Ziyang Hu ◽  
Tao Li ◽  
Ziyang Guo ◽  
Weiquan Luo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Ejection Fraction ◽  
Left Atrium ◽  
Left Atrial ◽  
Reversion Rate ◽  
Ejection Force ◽  
Left Atrial Ejection Fraction

We aimed to study the long-term sinus reversion rate and recovery of left atrial function after modified surgical radiofrequency ablation for permanent atrial fibrillation caused by mitral valve disease. From March 2014 to May 2020, 35 patients who underwent modified surgical radiofrequency ablation during cardiac valve surgery in our hospital were selected as the study group, and 25 normal individuals without cardiac structural changes were selected as the control group. The time of modified surgical radiofrequency ablation and long-term sinus reversion rate were measured, and left atrial anteroposterior, superoinferior, left and right diameters, left atrial ejection fraction, left atrial filling index, and left atrial ejection force were measured before and 6 months after surgery. The mean ablation time was 23.2 min, and the long-term sinus reversion rate was 80.0%. The left atrium diameter decreased and the left atrium ejection fraction increased after the operation ( P < 0.05 ). The left atrium filling index and ejection force were significantly increased in 28 patients with sinus reversion ( P < 0.05 ). The decrease in left atrial diameter and the increase in left atrial ejection fraction were correlated with sinus conversion after surgery ( P < 0.05 ). The modified operation is simple, the curative effect is definite, and the sinus reversion rate is high, which is beneficial to the restoration of left atrial structure, ejection function, and hemodynamic function.

scholarly journals CONCOMITANT PROCEDURE OF ATRIAL FIBRILLATION ABLATION WITH AND WITHOUT LEFT ATRIOPLASTY DURING SURGICAL CORRECTION OF THE MITRAL VALVE DISEASE: PROSPECTIVE, RANDOMIZED TRIAL

2018 ◽  
Vol 33 (3) ◽  
pp. 63-70
Author(s):  
A. V. Bogachev-Prokophiev ◽  
S. I. Zheleznev ◽  
M. A. Ovcharov ◽  
A. V. Afanasyev ◽  
R. M. Sharifulin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrium ◽  
Mitral Valve Disease ◽  
Left Atrial ◽  
Valve Disease ◽  
Atrial Ablation ◽  
Group I ◽  
Group Ii

Objective. Main objective of this prospective randomized study was to assess safety and efficiency of the combined approach for the left atrial ablation in combination with and without reduction left atrioplasty in patients with mitral valve disease.Material and Methods. The study was performed from September, 2014 to February, 2017. A total of 120 patients with mitral valve disease, permanent atrial fibrillation (AF), and left atriomegaly were enrolled in the study. Patients were randomized to two groups: group I comprised patients who received correction of mitral valve disease in combination with AF ablation and without reduction atrioplasty of the left atrium (MV+MAZE); group II (n=60) comprised patients with correction of mitral valve disease in combination with AF ablation and with reduction atrioplasty of the left atrium (MV+MAZE+AP). Patient characteristics did not differ between groups.Results. There were no significant differences between groups in the early mortality rates (2 patients in group I versus 5 patients in group II, p=0.64); bleeding rates (total 5 cases including 2 patients in group I and 3 patients in group II, p=0.34), and the rates of AF recurrence in the early postoperative period. Permanent pacemakers were implanted in 8 patients (13.3%) of group I and in 4 patients (6.7%) of group II. Total long-term mortality was 4 patients including 1 and 3 patients in group I and II, respectively, which did not significantly differed. The rates of one-year freedom from AF were 84.8 and 86.2% in group I and II, respectively. No new onsets of atrial fibrillation were observed for 36 months in both groups. The rates of freedom from thromboembolic events during the time of observation were 88.6% in group I and 96.5% in group II. Conclusion. The left atrial reduction concomitant with the left atrial ablation and correction of mitral valve disease is safe and effective procedure. However, this procedure did not impact the rates of long-term freedom from AF.

Abstract 17313: Myocardial Remodeling in Atrial Fibrillation is Not Associated With Supraventricular or Ventricular Ectopic Activity: Results From a Cardiac Imaging Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Dragana Rujic ◽  
Manan Pareek ◽  
Kenneth Egstrup
Keyword(s):  
Atrial Fibrillation ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Myocardial Strain ◽  
Imaging Study ◽  
Holter Monitoring ◽  
Myocardial Remodeling ◽  
Ectopic Activity ◽  
End Diastolic Volume ◽  
Left Atrial Ejection Fraction

Background: Myocardial remodeling in atrial fibrillation (AF) is a continuum of structural, hemodynamic, and electrophysical changes that often coexist in a complex pathophysiological interplay. Purpose: The aim of this study was to evaluate whether cardiac magnetic resonance imaging (CMR) derived myocardial strain, by tracking subtle alterations in myocardial function, was associated with premature atrial (PAC) and ventricular (PVC) complexes, detected by 7-day Holter-monitoring. Methods: A total of 95 patients (mean age 63±8.5 years, 52% male) with a history of paroxysmal (51%) or persistent AF (49%) underwent CMR and 7-day Holter-monitoring during sinus rhythm. Left atrial measures, including volume, ejection fraction, peak systolic longitudinal, radial and circumferential strain were assessed using cine CMR feature tracking by commercially available software (Circle, Calgary, Canada). Holter-monitoring was used to determine heart rate and rhythm, including the presence of PACs and PVCs. The associations between strain variables and Holter-variables were examined using multivariable linear regression, adjusted for age, sex, and AF type. Results: Left atrial end-diastolic volume was significantly increased, particularly in patients with persistent AF, when compared with healthy controls (persistent AF 132±32 ml vs. healthy 77±14 ml). Similarly, left atrial ejection fraction was significantly reduced in persistent AF as compared with normal reference values (48±10 ml vs. 54±10 ml). There were no significant associations between CMR strain parameters and average PACs per hour, average PVCs per hour, average PACs per sinus beats per hour or average PVCs per sinus beats per hour. These associations remained unaltered after adjusting for age, sex, and AF type. Finally, no significant interactions with AF type were found. Conclusions: Despite significant myocardial remodeling in left atrium shown by increased end-diastolic volume and decreased left atrial ejection fraction, there was no correlation with increased ectopic activity as assessed by 7-day ambulatory Holter monitoring. Image

scholarly journals Left Atrial Function after Atrial Fibrillation Cryoablation Concomitant to Minimally Invasive Mitral Valve Repair: A Pilot Study on Long-Term Results and Clinical Implications

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 709
Author(s):  
Anselmino ◽  
Rovera ◽  
Marchetto ◽  
Castagno ◽  
Morello ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Surface Area ◽  
Mitral Valve Repair ◽  
Body Surface ◽  
Left Atrial ◽  
Valve Repair

Background and Objectives: Surgical atrial fibrillation (AF) ablation concomitant to minimally invasive mitral valve repair has been proven to offer improved short- and long-term sinus rhythm (SR) maintenance compared to mitral valve surgery only. The objective of the present study was to explore, by thorough echocardiographic assessment, long-term morphological and functional left atrial (LA) outcomes after this combined surgical procedure. Materials and Methods: From October 2006 to November 2015, 48 patients underwent minimally invasive mitral valve repair and concomitant surgical AF cryoablation. Results: After 3.8 ± 2.2 years, 30 (71.4%) of those completing the follow-up (n = 42, 87.5%) presented SR. During follow-up, four (9.5%) patients suffered from cerebrovascular accidents and two of these subjects had a long-standing persistent AF relapse and were in AF at the time of the event, while the other two were in SR. An echocardiographic study focused on LA characteristics was performed in 29 patients (69.0%). Atrial morphology and function (e.g., maximal LA volume indexed to body surface area and total LA emptying fraction derived from volumes) in patients with stable SR (60.6 ± 13.1 mL/mq and 25.1 ± 7.3%) were significantly better than in those with AF relapses (76.8 ± 16.2 mL/mq and 17.5 ± 7.4%; respectively, p = 0.008 and p = 0.015). At follow-up, patients who suffered from ischemic cerebral events had maximal LA volume indexed to body surface area 61 ± 17.8 mL/mq, with total LA emptying fraction derived from volumes 23.6 ± 13.7%; patients with strokes in SR showed very enlarged LA volume (>70 mL/mq). Conclusions: AF cryoablation concomitant with minimally invasive mitral valve repair provides a high rate of SR maintenance and this relates to improved long-term morphological and functional LA outcomes. Further prospective studies are needed to define the cut-off values determining an increase in the risk for thromboembolic complications in patients with restored stable SR.

scholarly journals CATHETER ABLATION OF ATRIAL FIBRILLATION IN LEFT ATRIUM IN PATIENT WITH MECHANICAL MITRAL VALVE: ACUTE AND LONG-TERM RESULTS

2011 ◽  
Vol 57 (14) ◽  
pp. E17
Author(s):  
Rong Bai ◽  
Luigi Di Biase ◽  
Prasant Mohanty ◽  
Douglas Gibson ◽  
Salwa Beheiry ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Mitral Valve ◽  
Left Atrium ◽  
Long Term Results

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

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.

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

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.

Sign in / Sign up

Export Citation Format

Share Document