JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2015, Vol. 53 ›› Issue (5): 66-70.doi: 10.6040/j.issn.1671-7554.0.2014.479

Previous Articles     Next Articles

Radiofrequency modified maze Ⅲ plus ganglionic plexus ablation vs radiofrequency modified maze Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion

ZHANG Kai1, LIANG Fei1, HAN Bo2, MA Xiaochun1, ZHU Xiaolong1, ZHANG Jun1, ZHANG Tao1, ZOU Chengwei1   

  1. 1. Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shangdong, China;
    2. Department of Cardiac Surgery, The Forth People's Hospital of Jinan, Jinan 250031, Shangdon, China
  • Received:2014-07-22 Revised:2015-02-28 Online:2015-05-10 Published:2015-05-10

PDF (PC)

100

Abstract: Objective To compare the efficacy and safety of radiofrequency modified maze Ⅲ (RFMM Ⅲ) plus ganglionic plexus (GP) ablation with RFMM Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion. Methods A retrospective analysis was performed to analyze the clinical data of 200 patients who underwent RFMM Ⅲ plus GP ablation (n=100, GP group) or RFMM Ⅲ alone (n=100, solo group) in the treatment of atrial fibrillation with rheumatic mitral lesion. Results The sinus rhythm maintenance rate in the GP group was higher than that of the solo group 1, 6 and 12 months after operation (P=0.03, 0.02 and 0.03, respectively). The solo group showed a higher incidence of aggravating tricuspid regurgitation and more obvious left atria enlargement than the GP group 12 months after operation (P=0.03). Conclusion RFMM Ⅲ plus GP ablation, with higher sinus rhythm maintenancerate and lower recurrence rate, might be superior to RFMM Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion, which might effectively improve tricuspid regurgitation in patients undergoing mitral valve replacement and be beneficial for their long-term prognosis.

Key words: Radiofrequency Modified Maze Ⅲ, Ganglionic Plexus, Ablation, Atrial Fibrillation

CLC Number: 

  • R654.2
[1] Davy JM, Roubille F, Tri Cung T, et al. Atrial fibrillation in 2010: an increasing morbidity and mortality burden[J]. Ann Cardiol Angeiol (Paris), 2010, 59(suppl 1): 4-13.
[2] Healey JS, Parkash R, Pollak T, et al. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: etiology and initial investigations[J]. Can J Cardiol, 2011, 27(1): 31-37.
[3] Thrall G, Lane D, Carroll D, et al. Quality of life in patients with atrial fibrillation: a systematic review[J]. Am J Med, 2006, 119(5): 448-449.
[4] 何毅, 梅举. 心房颤动的外科治疗进展[J]. 中国心血管病研究, 2012, 10(7): 543-545.
[5] Saint LL, Bailey MS, Prasad S, et al. Cox-Maze IV results for patients with lone atrial fibrillation versus concomitant mitral disease[J]. Ann Thorac Surg, 2012, 93(3): 789-794.
[6] 许铭, 宋云虎. 心房颤动的外科治疗现状[J]. 中国循环杂志, 2010, 25: 154-156.
[7] Zhou J, Scherlag BJ, Edwards J, et al. Gradients of atrial refractoriness and inducibility of atrial fibrillation due to stimulation of ganglionated plexi[J]. Journal of cardiovascular electrophysiology, 2007, 18(1): 83-90.
[8] 程显峰, 梁飞, 张骞, 等. 同期射频消融改良迷宫Ⅲ术+心脏神经节丛消融治疗心房颤动[J]. 山东大学学报: 医学版, 2013, 51(2): 53-56. CHENG Xian feng, LIANG Fei, ZHANG Qian, et al. Treatment of atrial fibrillation with radiofrequency modified maze Ⅲ and ganglionic plexus ablation[J]. Journal of Shandong University: Health Sciences, 2013, 51(2): 53-56.
[9] Beaumont E, Salavatian S, Southerland EM, et al. Network interactions within the canine intrinsic cardiac nervous system: implications for reflex control of regional cardiac function[J]. J Physiol, 2013, 591(18): 4515-4533.
[10] Ardell JL, Randall WC. Selective vagal innervation of sinoatrial and atrioventricular nodes in canine heart[J]. Am J Physiol, 1986, 20(4): 764-773.
[11] Randall WC, Ardell JL, Calderwood D, et al. Parasympathetic ganglia innervating the canine atrioventricular nodal region[J]. J Auton Nerv Syst, 1986, 16(4): 311-323.
[12] Chiou CW, Eble JN, Zipes DP. Efferent vagal innervation of the canine atria and sinus and atrioventricular nodes. The third fat pad[J]. Circulation, 1997, 95(11): 2573-2584.
[13] Armour JA, Hopkins DA. Activity of canine in situ left atrial ganglion neurons[J]. Am J Physiol, 1990, 259(4 Pt 2): H1207-1215.
[14] Schauerte P, Scherlag BJ, Pitha J, et al. Catheter ablation of cardiac autonomic nerves for prevention of vagal atrial fibrillation[J]. Circulation, 2000, 102(22): 2774-2780.
[15] Pappone C, Santinelli V, Manguso F, et al. Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation[J]. Circulation, 2004, 109(3): 327-334.
[16] Abo-Salem E, Paone RF, Nugent K, et al. Stand alone surgical ablation for atrial fibrillation[J]. J Card Surg, 2013, 28(3): 315-320.
[17] Pokushalov E, Romanov A, Katritsis DG, et al. Ganglionated plexus ablation vs linear ablation in patients undergoing pulmonary vein isolation for persistent/long-standing persistent atrial fibrillation: a randomized comparison[J]. Heart rhythm, 2013, 10(9): 1280-1286.
[18] 杨嵩, 张希, 唐白云, 等. 永久性心房颤动外科双极射频消融术的效果[J]. 中国胸心外科血管外科临床杂志, 2012, 6(19): 254-257. YANG Song, ZHANG Xi, TANG Baiyun, et al. Outcomes of maze procedure using bipolar radiofrequency ablation for surgical treatment of permanent atrial fibrillation[J]. Chest Cardiac Vascular Surgery Clinical Magazine in China, 2012, 6(19): 254-257.
[19] Jiang Z, Ma N, Tang M, et al. Effect of novel modified bipolar radiofrequency ablation for preoperative atrial fibrillation combined with off-pump coronary artery bypass grafting surgery[J]. Heart Vessels, Doi:10.1007.
[20] Wu M, Zhang S, Dong A, et al. Long-term outcomes of maze procedure plus valve replacement in treating rheumatic valve disease resulting in atrial fibrillation[J]. Ann Thorac Surg, 2010, 89(6): 1942-1949.
[21] Ware AL, Suri RM, Stulak JM, et al. Left atrial ganglion ablation as an adjunct to atrial fibrillation surgery in valvular heart disease[J]. Ann Thorac Surg, 2011, 91(1): 97-102.
[1] WANG Ningning, QU Linli, CAO Fangli, LIANG Lei. Application of computed tomography sagittal reconstruction for microwave ablation of hepatic carcinoma under the diaphragm [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 71-75.
[2] DU Futian, DU Yunlong, LIN Hongfeng. A clinical research on occlusive techniques for partial splentic embolization combined with radiofrequency ablation for hypersplenism due to portal hypertension [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(7): 79-83.
[3] WEI Jinqiu, ZHANG Yujiao, LI Zhan, WANG Ximin, CHEN Linlin, DU Juanjuan, ZHANG Yong, XIE Xinxing, HOU Yinglong. Effects of GCH1 on atrial autonomic nerve remodeling by regulating tetrahydrobiopterin in A-TP canines [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 8-12.
[4] LI Man, ZHONG Jingquan, YUE Xin, ZHU Qing, ZHENG Zhaotong, RONG Bing, YI Shaolei, XIE Fei, ZHANG Yun. Effect of different circumferential pulmonary vein ablation endpoints on prognosis of atrial fibrillation patients:bidirectional block between pulmonary veins and left atrium [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(3): 62-68.
[5] ZHANG Fenglei, ZHENG Man, ZHANG Qi, GU Lei, XU Xinsheng. Clinical study on the association between metabolic syndrome and P wave dispersion [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(2): 52-55.
[6] ZHANG Lingli, ZHOU Ying, LI Xiaohe, LI Hui, ZHONG Ming, ZHANG Wei. Myocardial MMPs and TIMPs mRNA expressions in Chinese population with atrial fibrillation: a Meta-analysis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(1): 47-53.
[7] LI Cong, WANG Jianchun, ZHAO Yong, ZOU Chengwei, SUN Hui, ZHANG Qing. Association between calcineurin-nuclear factor of activated T cell pathway and atrial fibrillation in patients with valvular heart disease [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(8): 47-51.
[8] HAN Bo1,2, WANG Jianchun2, ZHANG Tao2, ZHU Xiaolong2, LI Cong2, WANG Zhengjun2, ZHAO Yong2, ZOU Chengwei2. Expression of calpain-2 in human left atrium in rheumatic atrial fibrillation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(4): 93-96.
[9] LIU Xiao-jun, ZHONG Jing-quan, YI Shao-lei, XU Zhen-xing, LI Man, ZHANG Yun. Electrocardiographic characteristics and radiofrequency catheter ablation of idiopathic ventricular tachycardias or premature ventricular contractions originating from the two non-classical sites [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(4): 42-46.
[10] CHENG Xian-feng, LIANG Fei, ZHANG Qian, ZHU Xiao-long, ZHANG Hai-zhou, ZHANG Tao, HAN Bo, ZOU Cheng-wei. Treatment of atrial fibrillation with radiofrequency modified maze Ⅲ and ganglionic plexus ablation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(2): 53-56.
[11] ZHENG Shao-hua1, ZHANG Yu-jiao1, LI Zhi-yuan2, HOU Xu-juan3, WANG Xi-min1, DUAN Wen-chang4, HOU Ying-long1. Autonomic neural remodeling of pulmonary vein-left atrium junction in a prolonged right atrial pacing canine model [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(12): 7-10.
[12] FU Kai-li1, ZHANG Xue-yi2, ZHU Meng3, WANG Zhi-hao1, WANG Hua1, ZHONG Ming1, ZHANG Yun1, ZHANG Wei1. Evaluation of stroke risks in patients with atrial fibrillation due to different pathogenesis [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2013, 51(06): 61-63.
[13] SUN Xue-lin1,2， BU Pei-li1， LIU Jun-ni1， CAO Guang-qing3， LI Li4， YU Qiong4. Relationship between SIRT1 expression in atrial tissue and
atrial fibrosis in patients with atrial fibrillation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(9): 68-72.
[14] HU Ke， CHEN Liang-hua， SONG Shang-ming， LIU Tong-bao. Clinical application of aortography and local electrophysiological characteristics at the aortic sinus cusps [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2012, 50(7): 92-96.
[15] WEI Zi-xiu, ZHANG Mei. Effect of Atorvastatin combined with Amiodarone on prevention of paroxysmal atrial fibrillation after dual-chamber-pacemaker implantation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2011, 49(2): 93-96.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd