నైరూప్య

Efficacy of non-cardioplegic radiofrequency ablation Maze-III procedure (RFA Maze-III) for the treatment of atrial fibrillation (AF) during the valve replacement surgery

Yang Yan, Lu-Qin Yan, Xiao-Jiang Yu, Wei-Jin Zang

Background: The non-cardioplegic surgery has a better myocardial protection compared to cardioplegic surgery. Combination of valve replacement surgery with RFA Maze-III procedure can achieve better clinical efficacy. The goal of this study was to evaluate the efficacy of RAF Maze-III under the noncardioplegic and mild hypothermic Cardiopulmonary Bypass (CPB) condition for the treatment of chronic Atrial Fibrillation (AF) during the valve replacement surgery.

Hypothesis: The non-cardioplegic RFA Maze-III is a safety and efficacy procedure for the treatment of AF during valve replacement surgery.

Methods: From 2007 to 2013, 84 consecutive patients with rheumatic heart disease and chronic AF underwent RFA Maze-III and heart valve replacement surgery in our hospital, 46 of which had noncardioplegic procedure. Continuous electrogram monitoring was performed to observe the cardioelectrical activities of patients during RFA Maze-III and valve replacement surgery. All the patients were follow-up with 24 h Holter and echocardiography in the perioperation and at 12 months after the operation.

Results: Sinus rhythm was recovered and maintained perioperatively in 73.7% (28/38) of cases in the cardioplegic group, which was significantly lower than that (91.3%, 42/46) in the non-cardioplegic group. One year after operation, sinus rhythm was maintained in 78.9% (30/38) of cases with cardioplegic surgery, which was significantly lower than that (89.1%, 41/46), in the group with noncardioplegic surgery.

Conclusion: Mild hypothermic non-cardioplegic surgery is feasible, safe and efficient in the treatment of AF by RFA Maze-III. In addition, non-cardioplegic operation simplifies the surgical procedure and makes the process more clearly.