The Changes in the Surgical Strategy and Clinical Results of AF Surgery According to the Development of Bipolar RF Ablation Devices

概要

論文の詳細を見る
Objective: We examined the changes in the surgical strategy and the midterm results of AF surgery after the advent of bipolar radiofrequency (RF) ablation devices. Methods: Ninety-four patients undergoing AF surgery were divided into two groups. In group 1 (G1), 17 patients underwent cut-and-sew Maze procedure. In group 2 (G2), 77 patients underwent AF surgery using bipolar RF clamp devices, including 43 Maze procedure (RF-Maze) and 34 pulmonary vein isolation (PVI). Mitral valvular disease was included in 88% of G1, otherwise 49% of G2. Paroxysmal AF was present in 12% of G1, otherwise 32% of G2. Results: (1) In patients undergoing Maze procedure, SR was restored in 100% of G1, and in 91% of G2 at midterm follow-up (mean 26 months), with comparable results. (2) In patients undergoing PVI in G2, SR was restored in 74%. In 21 patients undergoing PVI for paroxysmal AF, SR was restored in 95%. Meanwhile, in 13 patients undergoing PVI for persistent AF, in whom full Maze procedure had not been indicated because of its excess invasive procedure, SR was restored in 38%. Conclusion: According to the development of ablation devices, indication for AF surgery was extended. The outcome with RF-Maze was satisfactory and PVI seemed to have some value.