Kardiochirurgia dorosłych
Assessment of early and mid-term results of surgical treatment of atrial fibrillation in the Cardiac Surgery Department of the Pomeranian Medical University

Background:
To assess early and mid-term results of surgical treatment of atrial fibrillation using radiofrequency ablation.

Material and methods:
A prospective study of 36 consecutive patients operated on from February 2006 to November 2006 was performed. Mean ejection fraction was good: 52.1% (range 30-75%). Mean EuroSCORE logistic was 4.28%. Preoperatively mean LA diameter was 55.7 mm (range 40-100mm). 14 mitral rings, 18 mitral valve prostheses and 9 aortic valve prostheses were implanted. CABG alone or as a concomitant procedure was performed in 11 patients. Atrial fibrillation both paroxysmal and permanent was diagnosed in every case. Radiofrequency ablation of the left atrium using the MEDTRONIC Cardioblate system was performed as a concomitant procedure. All
patients had echocardiography performed pre- and postoperatively. The study performed 3 to 6 months after the procedure included physical examination, ECG and echocardiography.

Results:
Mean length of stay was 6.97 days. On the day of discharge from hospital 71.43% of patients were in sinus rhythm and 1 patient needed a pacemaker. Postoperative decrease of LA diameter (mean 44 mm, range 36-64 mm) was noticed, but mean ejection fraction remained unchanged: 55.3%. In follow-up, at 3-6 months after the operation the number of patients in sinus rhythm increased to 78.79%. A pacemaker was needed in two cases (6.06%). 15.15% of our patients remained arrhythmic. We noted 3 deaths after the operation on the 10th (stroke), 23rd (bleeding from gastrointestinal tract) and 17th (heart failure) post-operative day respectively.

Conclusions:
Radiofrequency ablation of the left atrium is
a safe and effective method of treating atrial fibrillation.