Microwave Ablation for Curative Treatment of Patients with Chronic Atrial Fibrillation and Concomitant Cardiosurgical Procedure - High Efficiency in Comparison to Isolated Cardiosurgical Procedures

Sems M.Tugtekin, Michael Knaut, Stefan G. Spitzer,Vassilios Gulielmos

Heart Center Dresden, University Hospital, Department of Thoracic and Cardiovascular Surgery, Dresden, Germany, Institute for Cardiovascular Research, Dresden, Germany

OBJECTIVE: Microwave ablation (MW) has been established as efficient treatment of chronic AF (cAF). Restoring of sinus rhythm (SR) is of major importance due to morbidity associated with cAF. Spontaneous follow-up of rhythm after isolated cardiosurgical intervention is of major interest in patients (pts) with cAF.We compared the follow-up of pts with cAF and cardiosurgical procedure with pts receiving MW as a concomitant procedure to cardiosurgical intervention.

METHODS: Group A included 62 pts (30 male, 32 female, age 72 ± 9 years, from 36-87 years, left atrial diameter 53 ± 9 mm, from 43 - 66 mm) suffering from mitral valve disease (n = 11), CAD (n = 35), or aortic valve disease (n = 16) with cAF documented for 6.9 ± 5.5 years. Cardiosurgical therapy included valve intervention or CABG. Group B included 91 pts (40 male, 48 female, age 67 ± 4 years from 26 - 83 years, left atrial diameter 52 ± 6 mm. from 42 - 84 mm) with documented cAF for 6.4 ± 4 years suffering from mitral valve disease (n = 49), CAD (n = 30), or aortic valve disease (n = 12). MW was performed as concomitant procedure.

RESULTS: In the one year-follow-up in group A 15% of pts with mitral valve disease , 11% with CAD and 0% of pts with aortic valve disease were SR. In group B 67% of pts with mitral valve disease, 72% with CAD, and 83% of pts with aortic valve disease were in SR.

CONCLUSIONS: Our results illustrate high efficiency of MW in pts with cAF and different concomitant cardiosurgical procedures based on different cardiac diseases in comparison to isolated cardiosurgical procedures.