Scopus
YÖKSİS Eşleşti
Left atrial radiofrequency ablation during mitral valve surgery for continuous atrial fibrillation: A randomized controlled trial
JAMA · Kasım 2005
YÖKSİS Kayıtları
Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation
JAMA · 2005 SCI-Expanded 61 atıf
PROFESÖR MEHMET ALKILIÇ HORASANI ÖÇ →
Makale Bilgileri
DergiJAMA
Yayın TarihiKasım 2005
Cilt / Sayfa294 · 2323-2329
Scopus ID2-s2.0-27744434527
Özet
Context: Although left atrial radiofrequency ablation (RFA) is increasingly used for the treatment of chronic atrial fibrillation during mitral valve surgery, its efficacy to restore sinus rhythm and any resulting benefits have not been examined in the context of an adequately powered randomized trial. Objective: To determine whether intraoperative RFA of the left atrium increases the long-term restoration of sinus rhythm and improves exercise capacity. Design, Setting, and Patients: Randomized, double-blind trial performed in a single UK tertiary referral center with enrollment between December 2001 and November 2003. A total of 101 patients referred for mitral valve surgery with at least 6 months' history of uninterrupted atrial fibrillation were assessed for eligibility; 97 were enrolled. Patients were followed up for 12 months. Intervention: Patients were randomly assigned to undergo mitral valve surgery and RFA of the left atrium (n=49) or mitral valve surgery alone (controls; n=48). Main Outcome Measures: The primary outcome measure was presence of sinus rhythm at 12 months; secondary measures were patient functional status and exercise capacity (assessed by shuttle-walk test), left atrial contractility, and left atrial and left ventricular dimension and function and plasma levels of B-type natriuretic peptide. Results: At 12 months, sinus rhythm was present in 20 (44.4%) of 45 RFA patients and in 2 (4.5%) of 44 controls (rate ratio, 9.8; 95% CI, 2.4-86.3; P<.001). Restoration of sinus rhythm in the RFA group was accompanied by a greater improvement in mean (SD) shuttle-walk distance compared with controls (+94 [102] m vs +48 [82] m; P=.003) and a greater reduction in the plasma level of B-type natriuretic peptide (-104 [87] fmol/mL vs -51 [82] fmol/mL; P=.03). Patients randomized to receive RFA had similar rates of postoperative complications and deaths as control patients. Conclusions: Radiofrequency ablation of the left atrium during mitral valve surgery for continuous atrial fibrillation significantly increases the rate of sinus rhythm restoration 1 year postoperatively, improving patient exercise capacity. On the basis of its efficacy and safety, routine use of RFA of the left atrium during mitral valve surgery may be justified. Trial Registration: ClinicalTrials.gov Identifier: NCT00238706. ©2005 American Medical Association. All rights reserved.
Yazarlar (8)
1
George Doukas
2
Nilesh J. Samani
3
Christos Alexiou
4
Mehmet Oc
ORCID: 0000-0002-7832-3067
5
Derek T. Chin
6
Peter G. Stafford
7
Leong L. Ng
8
Tomasz J. Spyt
Kurumlar
College of Life Sciences
Leicester United Kingdom
Glenfield Hospital
Leicester United Kingdom
Metrikler
157
Atıf
8
Yazar