Bipolar Radiofrequency Ablation For Atrial Fibrillation In Rheumatic Heart Disease

Objective:Patients with rheumatic heart disease whom underwent bipolar radiofrequency ablation(RF) or unipolar radiofrequency ablation were followed up. In order to compare unipolar RF and bipolar RF, and to evaluate the efficacy and safety of bipolar radiofrequency ablation for atrial fibrillation(AF) in rheumatic heart disease.Methods:Beginning April2011,100patients with rheumatic heart disease underwent radiofrequency ablation and were followed up for three times(the third months,the sixth months,the12th months). All of the patients had persistent or long-standing persistent AF.Unipolar radiofrequency ablation was used in40patients (there were23women and mean age was55.7±8.2years). The mean duration of AF was67.6±45.5months.The mean left atrial diameter was57.2±11.2mm.Bipolar radiofrequency ablation was used in60patients (there were38women and mean age was57.1±8.9years). The mean duration of AF was67.0±34.3months.The mean left atrial diameter was54.3±7.6mm. Patients were followed monthly with clinical examination electrocardiography and24-hour holter.Results:At12months79%of patients who underwent bipolar radiofrequency ablation were free from AF. And Collateral damage has not occurred in this series. At12months,67%of patients who underwent Unipolar radiofrequency ablation were free from AF. Three of them need implante permanent pacemaker.And there were the7%rate of postoperative left atrial flutter registered within the patients who were underwent bipolar RF.Conclusion:Bipolar RF ablation in patients submitted to valve surgery of rheumatic etiology is effective and safe in converting to sinus rhythm.