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Ann Thorac Surg 1998;65:1666-1672
© 1998 The Society of Thoracic Surgeons

Original articles: cardiovascular

Radiofrequency and Cryoablation of Atrial Fibrillation in Patients Undergoing Valvular Operations

Mien-Cheng Chen, MDa, G. Bih-Fang Guo, MD, PhDa, Jen-Ping Chang, MDb, Kuo-Ho Yeh, MDa, Morgan Fu, MDa

a Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
b Section of Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China

Accepted for publication January 30, 1998.

Address reprint requests to Dr Chen, Section of Cardiology, Chang Gung Memorial Hospital, 123, Ta Pei Rd, Niao Sung Hsiang, Kaohsiung Hsien 83305, Taiwan, Republic of China

Background. Previous studies have shown that the maze operation can restore sinus rhythm and atrial transport function in patients with chronic atrial fibrillation. The purpose of this study was to test the feasibility of the application of radiofrequency and cryoablation as an alternative to the classic maze operation.

Methods. Twelve patients undergoing mitral valve procedures were included in this study. Radiofrequency and cryoablation were applied to create lesions in both atria to simulate the classic maze operation.

Results. There were two surgical deaths. At the mean follow-up of 10.25 months for the remaining 10 patients; 6 were in sinus rhythm, 2 in atrial rhythm, 1 in paroxysmal atrial tachycardia, and 1 in atrial fibrillation. Doppler echocardiography at 6-month follow-up showed emergence of biatrial transport function in 3 patients and right atrial contractility in 8. At 12-month follow-up of 5 patients, Doppler echocardiography showed biatrial transport function in 3 and right atrial contractility in 4.

Conclusions. Our modified maze procedure during valvular operation is effective for achieving an acceptable success rate to restore sinus rhythm and atrial transport function in patients with chronic atrial fibrillation.




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