Comparative Research Of Left Atrial Ablation And Biatrial Ablation In The Surgical Treatment Of Atrial Fibrillation With Heart Valve Disease

Objective: To compare the operation results about left atrial ablation and biatrial ablation in surgical treatment of atrial fibrillation with valve disease.Methods: 100 cases of heart valve disease with atrial fibrillation who accepted surgical treatment in our hospital from September 2013-December 2014 were divided into two groups: 52 cases of left atrial ablation; 48 cases of Bi atrial ablation. Analysis of the two groups after radiofrequency ablation in sinus rhythm recovery rate and the factors that influence the recovery of sinus rhythm. After the diagnosis and clinical data were compared, including demographic data(gender, age, height, weight) and preoperative electrocardiogram, comprehensive echocardiography, chest X-ray or other examinations, intraoperative radiofrequency ablation time, cardiopulmonary bypass time, aortic cross-clamping time, postoperative ventilation time, ICU observation time, postoperative recovery of cardiopulmonary function(integrated echocardiography, contrast echocardiography comprehensive ECG). The rate of sinus rhythm maintenance and operation by comparing two groups of patients discharged from hospital after 3 months, and 6 months, and 1 year when the maintenance rate of sinus rhythm, to determine the two path ablation success rate. And analyze the influence of preoperative left atrial diameter and cardiac functional grading of sinus rhythm cardioversion rate.Results: Two groups of patients with perioperative period in there was no death and secondary thoracotomy for hemostasis and left atrial group appeared in 1 case of low cardiac output syndrome, 1 case of severe pulmonary infection, hypoxic ischemic encephalopathy in 1 case; biatrial group appeared in 1 case of low cardiac output syndrome, acute renal insufficiency in 1 case, severe pulmonary infection in 1 case. The patients were cured after discharge. Two kinds of operation mode in the postoperative sinus rhythm restoration were obtained good effect, after the return to the cardiac care unit, through 18 lead electrocardiogram diagnosis results to determine if restoration of sinus rhythm and left atrial group 96.15%, biatrial group 97.92%. Discharge arrhythmias and left atrial group in 6 cases(2 cases of atrial fibrillation and atrial flutter in 4 cases), sinus rhythm recovery rate: left atrial group was 88.46%, biatrial group in 5 cases(2 cases of atrial fibrillation and atrial flutter in 3 patients) in sinus rhythm recovery rate was 89.58%. Discharge the left atrial diameter echocardiography review was 46.12 ± 6.73 mm, there was statistical significance compared with that before operation. Left atrial ablation group has advantages in time, the operation of the two groups in the CPB time, total operative time, postoperative left atrial diameter, left ventricular diameter and EF value of the comparison, the difference was not statistically significant. 94 patients were followed up for 12 months. The sinus rhythm recovery rate was 79.79%, which left atrial sinus rhythm group recovery rate is 79.59%, biatrial was 80%, the difference between the two groups was not significant. Comparison of preoperative left atrial diameter and cardiac functional grading by chi-square test was the factors that affected atrial fibrillation turn to sinus rhythm after operation.Conclusion: Analysis of the results of this study, we believe that the heart valve disease patients underwent radiofrequency ablation in the treatment of atrial fibrillation, left atrial ablation and biatrial ablation have gained a high atrial fibrillation cardioversion rate and between the two groups had no difference significant, postoperative complications incidence similar, are both safe and high.