A Mid-term Follow-up Of Surgical Ablation For Atrial Fibrillation And A Primary Comparison Between Monopole And Bipolar Radiofrequency Ablation

Objective:To review the mid-term effect of maze procedure using monopole radiofrequency ablation in cardiac surgery and do a primary comparison between monopole radiofrequency ablation and bipolar radiofrequency ablation.Methods:237 patients who performed maze procedure using radiofrequency ablationg in 2007 and 2008 were followed up since procedure.Medtronic monopole radiofrequency ablation was used in 210 cases,Medtronic bipolar system was used in 13 cases,Atricure bipolar radiofrequency ablation was use in 14 cases.Results:1.193 cases have been followed up,the follor up rate is 81.43%,171 cases with monopole radiofrequency ablation and 22 cases with bipolar radiofrequency ablation.One patient died in perioperative period,2 died in 3 month after surgery,3 stroke happened and pace-maker installed in 4 cases.2.In the monopole radiofrequency ablation group,the instanct rate of elimination of atrial fibrillation was 99.42%,the rate was 72.78%in 3 month after procedure,while 74.83%in 6 month and 71.30%in one year.3.In the monopole radiofrequency ablation group,the patients with larger left atrium(left atrial diameter＞65mm) has a lower elimination rate of atrial fibrillation.The Left atrial diameter is a risk factor in recurrence of atrial fibrillation(P＜0.05).4.Compared with monopole,bipolar radiofrequency ablation procedure has no better elimination rate of atrial fibrillation and no improvement in cardiac function(P＞0.05).Compared with Atricure bipolar radiofrequency,Medtronic bipolar radiofrequency procedure has no better elimination rate of atrial fibrillation and no improvement in cardiac function(P＞0.05).Conclusion:1.It is safe to perform maze procedure with radiofrequency ablation in cardiac surgery.2.The left atrial diameter was an independent influence factor to the efficacy of monopole radiofrequency ablation maze procedure.3.In a primary comparison,the efficacy of perform maze procedure using bipolar radionfrequency was no better than using monopole radiofrequency,there was no statistical significance.