| Background: Atrial fibrillation is a kind of common cardiac arrhythmia in clinic, its Morbidity is 0.15-1.00%, which has a high risk factor of stroke in patients with 5-7 times higher morbidity than non atrial fibrillation person. Either medicine or catheter radiofrequency ablation respectively have no ideal recovery effect. therefore surgery cure of atrial fibrillation was highly concerned and expected. In 1987 ,Cox firstly carry out Maze operation, and improved it twice after.As it developed till now ,Mazeâ…¢oper is the standard disposal of surgical treatment of atrial fibrillation. But Mazeâ…¢oper has its disadvantages such as complex ,cost of time, hemorrhage, complication in perioperational days. modifications of Mazeâ…¢oper by multiple source of energy such as radiofrequency , refrigeration,microwave,laser and so on were tested in stead of cutting and suture. But of all those techincs have two shortages, the one is no able to accomplish atrial penetration damage thoroughly and rapidly. The other is unavoidable paradamage. AtriCure bipolar radiofrequency ablation system overcomed the problems mentioned above. It is now used by several US hospitals to treat a number of atrial fibrillation patients ,obtaining the judgement of simple, safe and efficiency .May 2005 ,we introduced this techinc first interal , treated rheumatic valvular heart disease combine with atrial fibrillation ,It got good cure rate too.Objection:a group of cases of rheumatic valvular heart disease combine with atrial fibrillation were treated by valve replacement(valvuloplasty) and bipolar radiofrequency ablation system modified Mazeâ…¢operation . Clinical statistics before within and after operation were analysed to evaluated its cure effect.Method: 70 rheumatic valvular heart disease combine with atrial fibrillation cases treated by valve replacemenoperated(valvuloplasty) in cardiovascular surgery department of the second hospital jilin university consisted from May 2005 to December 2007. Send the cases randomly to 2 groups randomly.Trial group undergone valve replacement operations(valvuloplasty),while treatment atrial fibrillation by bipolar radiofrequency ablation system .Control group only undergone valve replacement operations(valvuloplasty).Operation length , extracorporeal circulation minutes, blocking minutes, draining quantity during 24h after operation,respirator supported days ,ICU days, complications,ECGs(in the operation day in hospital and 1 week ,1 month ,3 months ,6 month ,12 month after operation by follow up visit ) are collected and analysed statisticly.Results: Follow up rate of this group is 100%. There are not significantly different between trial group and control group in the expect of operation minutes, arteriae aorta blocking time, draining quantity 24hs after operation, respirator supported days, ICU days.while extracorporeal circulation minutes of trial group is 20 minutes longer than that of control group with significant difference. There are no death and any other complications related to bipolar radiofrequency ablation system modified Mazeâ…¢operation in trial group. Recovery rate of artial fibrillation in the trial group by the day of operation and 1 week ,1 month ,3 month after operation are 91.4%,82.9%,91.4%,94.3% respectively, Which are significantly higher than that of trial group(28.6%,11.4%,8.6%,5.7%). 28 cases are following up to 6 month , 26 cases are sinus rhythm in ECGs, the recovery rate of artial fibrillation is 92.9%. 14 cases are following up to 12 months ,which are all sinus rhythm in ECGs, recovery rate is 100.0%.Conclusion: AtriCure bipolar radiofrequency ablation system modified Mazeâ…¢operation is a kind of newly developed, rapid, safe and efficient technic. Its recovery rate of artial fibrillation is similar with traditional Mazeâ…¢operation. Besides, it get rid of disadvantages of traditional Mazeâ…¢operation, such as complex, cost of time, hemorrhage, complication in perioperational days. |
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