The Analysis Of Clinical Effect Of Modified Radiofrequency Ablation Of Atrial Fibrillation Using Bipolar Radiofrequency Pen With Total Thoracoscopic Mitral Valve Surgery

Objective:To analyze the clinical effect of total thoracoscopic mitral valve surgery performed simultaneously with modified radiofrequency ablation of atrial fibrillation using bipolar radiofrequency pen,including sinus recurrence rate and effect on left ventricular ejection fraction.Methods:From January 2016 to April 2022,this center(the First Affiliated Hospital of Jinan University)was included in this study.A retrospective case-control study was conducted on the patients who underwent total thoracoscopic mitral valve surgery by the same surgeon.According to valve surgery patients have the same line of radiofrequency ablation cases can be divided into two groups:concomitant modified radiofrequency ablation of atrial fibrillation using bipolar radiofrequency pen group(group A)and mitral valve surgery group(group B),only through the perioperative data,the analysis of the intraoperative and postoperative complications,verify the thoracoscope mitral valve surgery over the same period line feasibility,safety,improvement of radiofrequency ablation of atrial fibrillation.Results:A total of 98 patients were included in the study,and all patients successfully completed surgery without death.There were 47 patients in group A and 51 patients in group B.After analysis,it was found that compared with group B,the mean CPB time was 179.00±29.20 vs.144.78±29.96min(p<0.01),and the mean aortic occlusion time was 107.70±19.10 vs.80.68±15.78min(p<0.01),p<0.05,the difference was statistically significant.The average SICU residence time was 80.85±35.26 vs.72.71±36.40h(p=0.26)and the average duration of ventilator assistance was 22.40±13.28 vs.21.26±15.15h(p=0.69),with no statistical significance.The rates of sinus recurrence 1 week,3 months and 12 months after surgery were 53.19% vs.13.33%,74.47%vs.3.92% and 63.83% vs.17.65%,respectively,and group A was higher than group B.LVEF was61.68±7.31% vs.61.96±7.22%(p=0.76),p>0.05,the difference was not statistically significant.LVEF was 62.66±7.50% vs.59.34±6.72% 3 months after surgery(p=0.046),p<0.05,the difference was statistically significant.There were 4 postoperative complications in group A,including one case of sick sinus syndrome,one case applied intra-aortic balloon pumping,one case of poor wound healing,and one case of permanent pacemaker implantation.There were 3postoperative complications in group B,including 1 case of secondary thoracotomy for hemostasis and 2 cases of poor postoperative wound healing.Conclusion:The simultaneous use of bipolar radiofrequency pen for modified atrial fibrillation radiofrequency ablation in total thoracoscopic mitral valve surgery did not significantly increase the operation time,postoperative recovery time,and the incidence of postoperative complications.Compared with thoracoscopic mitral valve surgery alone,the sinus conversion rate was more than60% one year after surgery.Meanwhile,it can improve the left ventricular ejection fraction in the near and middle postoperative period.