Background. Eight-year clinical results of surgical bipolar radiofrequency (BRF) atrial fibrillation (AF) ablation were analyzed. Methods. One-hundred-twenty-two patients undergoing BRF without (n=57) or with (n=65) concomitant right atrial (RA) ablation were assessed for sinus rhythm recovery at a median follow up of 38.8 months (27.0-86.5). A competing risk model was used to appropriately estimate the incidence of AF and surgical techniques were analysed for their association with AF recurrence employing a competing risk regression corrected for atrial dimensions using sub-hazard ratios (SHRs) as measure of association. Results. The percentage of patients in normal sinus rhythm and offantiarrhythmic drugs were 75.4% (n=43) in the RA ablation and 56.9% (n=37) in the no-RA ablation Groups (p<0.001). Eight-year cumulative incidence of AF recurrence was significantly lower in the Group receiving RA lines (Figure 1). The absence of RA ablation (SHR 3.84 95% CI 1.27-6.48, p=0.001) was the only surgical factor independently associated with AF recurrence at follow up. Roof (SHR 1.54 0.61-3.84, p=0.233), inferior (SHR 1.39 0.42-3.39, p=0.30) left appendage-to pulmonary veins (SHR 1.56 0.87-4.06, p=0.112) and mitral isthmus (SHR 1.67 0.94-4.23, p=0.151) lines were not significant. Conclusions. Our experience suggests that a right-sided ablation should be routinely added to BRF left atrial ablation for atrial fibrillation. Further studies are necessary to confirm our results.

IMPACT OF RIGHT ATRIAL LINES ON EIGHT-YEAR RHYTHM OUTCOME FOLLOWING BIPOLAR RADIOFREQUENCY MAZE / Lucà F., La Meir M., Puntrello C., Rostagno C., Rubino G., Lozekoot P., Francese G.M., Renzulli A., Rao C.M., Puntrello G., Benedetto F.A., Gensini G.F., Maessen J., Gulizia M.M., Gelsomino S.. - In: GIORNALE ITALIANO DI CARDIOLOGIA. - ISSN 1972-6481. - ELETTRONICO. - (2015), pp. 161-161.

IMPACT OF RIGHT ATRIAL LINES ON EIGHT-YEAR RHYTHM OUTCOME FOLLOWING BIPOLAR RADIOFREQUENCY MAZE

Rostagno C.;RAO, CARMELO MASSIMILIANO;Gensini G. F.;Gelsomino S.
2015

Abstract

Background. Eight-year clinical results of surgical bipolar radiofrequency (BRF) atrial fibrillation (AF) ablation were analyzed. Methods. One-hundred-twenty-two patients undergoing BRF without (n=57) or with (n=65) concomitant right atrial (RA) ablation were assessed for sinus rhythm recovery at a median follow up of 38.8 months (27.0-86.5). A competing risk model was used to appropriately estimate the incidence of AF and surgical techniques were analysed for their association with AF recurrence employing a competing risk regression corrected for atrial dimensions using sub-hazard ratios (SHRs) as measure of association. Results. The percentage of patients in normal sinus rhythm and offantiarrhythmic drugs were 75.4% (n=43) in the RA ablation and 56.9% (n=37) in the no-RA ablation Groups (p<0.001). Eight-year cumulative incidence of AF recurrence was significantly lower in the Group receiving RA lines (Figure 1). The absence of RA ablation (SHR 3.84 95% CI 1.27-6.48, p=0.001) was the only surgical factor independently associated with AF recurrence at follow up. Roof (SHR 1.54 0.61-3.84, p=0.233), inferior (SHR 1.39 0.42-3.39, p=0.30) left appendage-to pulmonary veins (SHR 1.56 0.87-4.06, p=0.112) and mitral isthmus (SHR 1.67 0.94-4.23, p=0.151) lines were not significant. Conclusions. Our experience suggests that a right-sided ablation should be routinely added to BRF left atrial ablation for atrial fibrillation. Further studies are necessary to confirm our results.
2015
Lucà F., La Meir M., Puntrello C., Rostagno C., Rubino G., Lozekoot P., Francese G.M., Renzulli A., Rao C.M., Puntrello G., Benedetto F.A., Gensini G.F., Maessen J., Gulizia M.M., Gelsomino S.
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1113363
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