Tamer TÜRK, Cüneyt ERİŞ, Şenol YAVUZ, Derih AY, Arif GÜCÜ, Gündüz YÜMÜN, Faruk TOKTAŞ, Yusuf ATA

Mitral Kapak Replasmanı ile Beraber Unipolar Radyofrekans Ablasyonun Atriyal Fibrilasyon Üzerine Etkisi

Amaç: Bu çalışmanın amacı mtiral kapak replasmanı uygulanan persistan atriyal fibrilasyonlu AF hastalarda unipolar radyofrekans ablasyon etkinliğinin araştırılmasıdır. Yöntem: Çalışmamıza, Ocak 2010- Ocak 2012 tarihleri arasında kliniğimizde mitral kapak replasmanı uygulanan ve beraberinde sol atriyal ablasyon uygulanan 22 hasta dahil edildi. Hastaların postoperatif ve orta dönem kontrol 12 derivasyonlu EKG kayıtları geriye dönük olarak değerlendirildi. Hastaların operasyon sonrası 6 ay boyunca takip edilmesi planlandı. Bulgular: Kardiyopulmoner bypass çıkışında 14 %63,6 hastada normal sinüs ritmi sağlandı, 1 hasta geçici pace desteğinde olmak üzere 8 36,3 hasta AF ile yoğun bakıma alındı. Erken dönemde 1 hasta düşük debi ve uzamış entübasyon nedeniyle kaybedildi. 1.ay sonunda 15 hasta %71,4 sinüs ritminde, 6 hastada % 28,6 atriyal fibrilasyon devam etmekteydi. Atriyal fibrilasyon ile takip edilen bir hastaya postoperatif 10. ayında kalıcı pace implante edildi. 6.ay sonunda tekrarlayan atriyal fibrilasyon olmadı. Sonuç: Sol atriyal unipolar radyofrekans ablasyon tedavisinde elde edilen başarı literatür bulguları ile uyumlu olarak bulundu. Çalışmamız sonucunda, hasta yaşı ve pulmoner hipertansiyon postoperatif devam eden AF için prediktif olarak değerlendirilmiştir.

Anahtar Kelimeler:

Atriyal fibrilasyon, Mitral kapak replasmanı, Radyofrekans ablasyon

Effect of mitral valve replacement with unipolar radiofrequency ablation of atrial fibrillation

Objective: The aim of this study is to investigate the effectiveness of unipolar radiofrequency ablation in patients with persistent atrial fibrillation undergoing mitral valve replacement. Method: Our study consists of 22 patients, who performed mitral valve replacement with associated left atrial ablation in our clinic between January 2010 and January 2012. Postoperative early and mid-term follow-up of the patients were retrospectively evaluated with 12-lead electrocardiographic recordings. The patients were followed up during 6- month period. Results: After cardiopulmonary bypass, 14 63.6% patients maintained normal sinus rhythm, 8 patients including one patient with a temporary pace support has AF on time received to the intensive care unit. In the early period, one patient died due to low flow, and prolonged intubation. At the end of the first month, 15 71.4 % patients were in sinus rhythm, and 6 patients 28.6% were with atrial fibrillation persisted. Followed by the tenth postoperative atrial fibrillation in a patient was implanted permanent pace. At followup 6th month, there was recurrent atrial fibrillation.Conclusion: The success achieved with the unipolar radiofrequency left atrial ablation was found to be consistent with the findings of the literature. In our study, patient age and pulmonary hypertension was evaluated as predictive of ongoing postoperative AF.

Keywords:

Atrial fibrillation, Mitral valve replacement, Radiofrequency ablation,

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