Effects of Pulmonary Vein Isolation Using Intraoperative Radiofrequency Catheter Ablation for the Treatment of Atrial Fibrillation Associated with Mitral Valvular Heart Diseases

Abstract

Background and Objectives:The pulmonary veins and surrounding ostial areas frequently house focal triggers or reentrant circuits critical to the genesis of atrial fibrillation (AF). The purpose of this study was to assess the efficacy of pulmonary vein isolation, aided by intraoperative radiofrequency catheter ablation, for the treatment of AF associated with mitral valvular heart disease. Subjects and Methods:32 consecutive patients with AF associated with mitral valvular disease, requiring mitral valvular replacement or valvuloplasty were included. We divided these patients into two groups. The first group, PVI, consisted of 16 patients that had mitral valvular operations with intraoperative radiofrequency pulmonary vein isolation, and the other 16 patients, the controls, had mitral valvular operation only. The conversion rate to sinus rhythm and other clinical data were compared between the two groups. Results:Circumferential pulmonary vein isolation, with radiofrequency catheter ablation, was achieved in an average of 15±3 min. There were no mortalities or morbidities associated with this procedure. In the immediate postoperative period, the conversion rate to normal sinus rhythm in the PVI group was significantly higher than in the controls (81% vs. 37.5% p=0.016). After 21±4 weeks of follow up, the sinus rhythm maintenance rates in PVI group was also significantly higher than those of the control group (75% vs. 31.2% p=0.01). Conclusion:Circumferential pulmonary vein isolation, aided by intraoperative radiofrequency catheter ablation, is simple and effective for the treatment of chronic atrial fibrillation associated with mitral valvular disease. (Korean Circulation J 2002;32(7):596-603)