The clinical study of circumferential ablation around orifice of pulmonary vein by radiofrequency energy with chronic atrial fibrillation undergoing rheumatic valvular heart surgery

Objective To evaluate the clinical efficiency of circumferential ablation around orifice of pulmonary vein by radiofrequency(RF)energy in the cure of chronic atrial fibrillation(AF)in patients with rheumatic valvular disease.Methods Radiofrequency catheter ablation was performed in 20 patients with rheumatic valvular disease and chronic AF who underwent heart valve surgery.The ablation temperature was 50—60℃and the linear RF ablations were performed encircling the four openings of pulmonary veins and connecting the posterior mitral annulus with the probe made by ourselves especially for this ablative procedure.And amiodarone was given from the third day before the surgery and lasted for 3 months thereafter.Twenty patients with chronic AF who underwent valvular surgery but refused RF ablation were considered as the control group.Results Sinus rhythm(SR)restored in 19 patients either spontaneously or after intraoperative direct current cardioversion,immediately after the operation,as compared with 16 patients in the control group.During the follow-up(24±3)months,16 of 20 patients(80%)remained in sinus rhythm in patients received ablation,but in control group,SR was presented in only 7 of 20 patients (35%).Conclusions Circumferential ablation around orifice of pulmonary vein by RF energy is safe and effective in restoration and maintenance of SR in patients with rheumatic valvular disease and chronic AF.