| Objective:This study retrospectively anlalyzed AF recurrence rate in most patients who underwent valve replacement procedures combined with RF ablation to treat AF in our department. We compared the information and clinical date in the sinus rhythm(SR)group with in tile AF recurrence group to analyze the relationship between various preoperative risk factors and operation failure. The aim of this study is to provide evidence to select patients who can benefit most from this type of surgery.Methods:From June2010to June2011,50patients with rheumatic heart disease(RHD) and chronic AF underwent RF ablation concomitant with valve replacement in our department by a same surgron with with the same metllod. Preoperative and intraoperative data was retrospectively collected and all patients were followed up six months to determine the type of heart rhythm.Operation failure was defined as showing any rhythm except normal sinus rhythm by electrocardiogram. We divided all patients to the A (sinus rhythm)grope and B(atrial fibrillation/atrial flutter) grope. Univariate and multivariate statistical analysis was used to compare the data between the two groups in pre-, intra-and postoperative period. Results:All the patients recoverd. None mortality, re-exploration for bleeding and pacemaker implantation for malignant arrhythmia was shown during the mean follow-up,period of6months. At the last follow-up, sinus rhythm was shown in72%(36/50)patients. The left atrial diameter, AF duration and Valve disease types were predictors of recurrence of AF. Age, left ventricular ejection factor, Aortic clump time,cardiopulmonaqby bypass time showed no significant difference between the two gropes.Conclusion:RF ablation concomitant with valve replacement is an effective way to treat AF for those patients who need open heart Surgery at the same time. Success rate was72%.Different types of Valvular heart disease a different mechanism to Trigger atrial fibrillation. Preoperative duration of AF was the independen risk factor of AF recurrence.The longer the duration of AF is, the worse the efficacy of this procedure to restore nomal SR is. Especially in the patients with rheumatic mitral stenosis. The treatment of AF is limited,we need to find out the real mechanism of atrial fibrillation to get better curative effect. |
