Pulmonary Vein Isolation For Treatment Of Permanent Atrial Fibrillation During Heart Valve Surgery

Objectives: To evaluate effectiveness of the self-designed radiofrequency pen and to assess the efficacy of surgical isolation of the pulmonary veins for re-establishing sinus rhythm in patients with permanent atrial fibrillation secondary to rheumatic heart disease. Methods: Ablations of the atrial endocardium by using the self-designed radiofrequency pen were performed on 6 pig hearts in vitro. Consecutive 28 permanent atrial fibrillation patients with rheumatic heart disease were divided into 2 groups including surgical valvular treatment associated with surgical isolation of the pulmonary veins (isolation group, n=18) and surgical valvular treatment (control group, n=10). Result: The transmural lesions was pathologically confirmed in all areas ablated at 38.93 ±7.89W RF for 35.07±12.98 sec. 72% (13/18) patients in isolation group and 10 % (1/10) patients in control group had sinus rhythm over 12 months after electrical cardioversion (Ig vs. Cg P=0.004). Conclusions: The radiofrequency pen facilitates a quick and safe atrial endocardial ablation. Electrical isolation of the pulmonary veins associated with mitral valve surgery is an effective and safe technique for maintaining sinus rhythm in patients with permanent atrial fibrillation.