medigraphic.com
SPANISH

Revista de Especialidades Médico-Quirúrgicas

Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2011, Number 4

<< Back Next >>

Rev Esp Med Quir 2011; 16 (4)

Atrial fibrillation: surgical management with ablation by radiofrequency. Experience at the Cardiovascular Surgery Service, CMN 20 de Noviembre, ISSSTE

García OMS, Tarelo SJM, Díaz QG
Full text How to cite this article

Language: Spanish
References: 9
Page: 235-239
PDF size: 321.12 Kb.


Key words:

atrial fibrillation, ablation, radiofrequency.

ABSTRACT

Background: Atrial fibrillation is the most frequent cardiac arrhythmia that increases with aging and with some left valve disease, especially those of mitral location. Recently, therapeutic resources for the correction of this condition have increased, among which the surgical aspect plays a key role.
Objective: To evaluate the effectiveness of the endocardic ablation by radio-frequency at the Service of Cardiovascular Surgery of CMN 20 de Noviembre, ISSSTE.
Patients and method: We made an observational, longitudinal, descriptive and retrolective study at CMN 20 de Noviembre, ISSSTE. We reviewed the evolution of the cases of mitral valve operated from January 2006 to January 2007 with atrial fibrillation. These patients underwent to an ablation with radiofrequency in transoperatory period.
Results: We included 25 patients, 16 women, with age of 34 to 71 years (average of 53.9 ± 9.5), 9 with double mitral injury, 13 with double mitral injury plus tricuspid insufficiency and 3 with intra-auricular thrombus in addition to diagnoses previously mentioned. Average time of the atrial fibrillation was 14.4 months, the size of the left auricle was of 51.5 to 88.5 mm, with an average of 66 ± 9 mm; the waves of fibrillation were predominantly smaller than 1 mm (0.95 mm); time of clamp was 44 to 53 min, with an average of 91.1 ± 21.6, and pump from 211 to 66 min, with an average of 113.8 ± 32.3 min; the time of follow-up was 5-18 months, with an average of 10.7 ± 3.9, and the percentage of patients that maintained sinusal rate was of 76% to 18 months.
Conclusions: We concluded that the endocardic ablation by radiofrequency is a simple method that allows the aggression in an important percentage of the patients with atrial fibrillation that require, in addition, surgery to mitral valve, this substantially does not prolong the time of clamp and pump and increases in non significant way the morbidity of the patients who underwent cardiac surgery.


REFERENCES

  1. Ramírez S, Sandoval N, Cervantes J. Tratamiento quirúrgico de la fibrilación auricular crónica asociada a valvulopatía mitral. Arch Cardiol Mex 2006;76:S2,200-3.

  2. Earley M, Showkatthali R, Alzetani M, Kistler P, et al. Radiofrequency ablation of arrhythmias guided by nonfluoroscopic cateter location: a prospective randomized trial. Eur Heart J 2006;27:1223-1229.

  3. Silva R, Mont L, Berruezo A, Fosch X, et al. Radiofrequency ablation in the treatment of focal atrial fibrillation using circumferential mapping and segmentary disconnection of pulmonary veins. Rev Esp Cardiol 2003;56(4):361-367.

  4. Goodacre S, Irons R. Atrial arrhythmias. BMJ 2002;(324):594-598.

  5. Khargi K, Hutten B, Lemke B, Deneke T. Surgycal treatment of atrial fibrillation. A systematic review. EJTCS 2005;27:258-265.

  6. Jahangir M, Weir G, Mandal K, Savelieva I, Camm J. Current strategies in the management of atrial fibrillation. Ann Thorac Surg 2006;82:357-364.

  7. Guillinov A, Blackstone E, McCarthy P. Atrial fibrillation: Current surgical options and their assessment. Ann Thorac Surg 2002;74:2210-2217.

  8. Pappone C, Santinelli V. Atrial fibrillation ablation: State of the art. Am J Cardiol 2005;96(Supl):59L-64L.

  9. Barnett S, Ad N. Surgycal ablation as treatment for elimination of atrial fibrillation: A meta-analysis. J Thorac Cardiovasc Surg 2006;131:1029-1035.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Esp Med Quir. 2011;16