INTRAOPERATIVE RADIOFREQUENCY AND CRYOABLATION FOR ATRIAL FIBRILLATION IN PATIENTS WITH VALVULAR HEART DISEASE

Patients with valvular heart disease and suffering from atrial fibrillation of more than 12months duration have a low probability of remaining in sinus rhythm after valve surgery alone. weperformed intra-operative radiofrequency ablation or cryoablation as an alternative to surgical maze ²²²procedure to create linear lesions for conversion of this arrhythmia to sinus rhythm. a total of 30 patientswith valvular heart disease and chronic persistent atrial fibrillation underwent different combinations ofvalve surgery and concomitant maze procedure with radiofrequency or cryo probes. these patients aged48.10 ± 9.84 years in radiofrequency ablation group and 51.10 ± 13.93 years in cryoablation group.biatrial ablation with radiofrequency probes needed 26.15 ± 3.67 min extra ischemic time and ablation bymeans of cryo-probes needed an extra ischemic time of 29.62 ± 4.27 min. there was no mortality exceptone in-hospital death postoperatively because of respiratory failure. six months after the operation, among30 patients with biatrial ablations, 25 patients were in sinus rhythm, no patient had junctional rhythm and5 patients had persistent atrial fibrillation. at 12 months follow up, freedom from atrial fibrillation was85% in radiofrequency group and 80% in cryo group. doppler echocardiography in these patientsdemonstrated atrial contractility in 70% of the patients. intraoperative radiofrequency or cryo-ablation ofboth atriums are effective and less invasive alternatives for the original maze procedure to eliminate theatrial fibrillation and can be done in patients with valvular heart disease without increasing the risk ofoperation.