Combined Atrial Septal Defect Surgical Closure and Irrigated Radiofrequency Ablation in Adult Patients

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Abstract

Background: Atrial arrhythmias are relatively common among patients over 40 years old with atrial septal defect (ASD) and are a precipitating cause of heart failure. Surgical closure of the ASD in these patients is feasible and is associated with a low mortality rate and a beneficial effect on the clinical status; however the occurrence of atrial arrhythmia does not decrease after surgery. We present the results of our preliminary experience with surgical ASD closure combined with intraoperative irrigated radiofrequency (IRF) ablation in adult patients. Methods: During a 26-month period between September 2002 and December 2004, 15 patients more than 40 years old with ASD and atrial arrhythmia underwent elective surgical closure of the defect and intraoperative IRF ablation. All patients had supraventricular arrhythmias: 8 had permanent atrial fibrillation, whereas 7 had previous episodes of atrial flutter or intra-atrial reentry tachycardia. The biatrial approach (Cox-Maze III procedure) was used in 7 patients and a right-sided Maze procedure (ablation lines on the right atrium only) was carried out in the remaining 8 patients. Results: All patients survived the procedure. Fourteen patients left the operating room in sinus rhythm and 1 had a pacemaker implanted. There were no complications resulting from the IRF ablation. All 15 patients survived over the average follow-up period of 24 months. Thirteen patients were still in sinus rhythm, 1 had pacemaker rhythm, and only 1 (1 of 15; 6.5%) suffered a recurrence of atrial fibrillation 3 months after the procedure. Conclusions: We suggest adding intraoperative IRF ablation during surgical closure of an ASD in all adult ASD patients with arrhythmias. The IRF ablation is easy to perform, safe, and effective.

Original languageEnglish
Pages (from-to)1327-1331
Number of pages5
JournalAnnals of Thoracic Surgery
Volume82
Issue number4
DOIs
Publication statusPublished - Oct 2006

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Atrial Heart Septal Defects
Cardiac Arrhythmias
Atrial Fibrillation
Atrial Flutter
Patient Rights
Operating Rooms
Heart Atria
Tachycardia
Heart Failure
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

@article{8bae5621beeb413790fdaa1e4c6e6ca1,
title = "Combined Atrial Septal Defect Surgical Closure and Irrigated Radiofrequency Ablation in Adult Patients",
abstract = "Background: Atrial arrhythmias are relatively common among patients over 40 years old with atrial septal defect (ASD) and are a precipitating cause of heart failure. Surgical closure of the ASD in these patients is feasible and is associated with a low mortality rate and a beneficial effect on the clinical status; however the occurrence of atrial arrhythmia does not decrease after surgery. We present the results of our preliminary experience with surgical ASD closure combined with intraoperative irrigated radiofrequency (IRF) ablation in adult patients. Methods: During a 26-month period between September 2002 and December 2004, 15 patients more than 40 years old with ASD and atrial arrhythmia underwent elective surgical closure of the defect and intraoperative IRF ablation. All patients had supraventricular arrhythmias: 8 had permanent atrial fibrillation, whereas 7 had previous episodes of atrial flutter or intra-atrial reentry tachycardia. The biatrial approach (Cox-Maze III procedure) was used in 7 patients and a right-sided Maze procedure (ablation lines on the right atrium only) was carried out in the remaining 8 patients. Results: All patients survived the procedure. Fourteen patients left the operating room in sinus rhythm and 1 had a pacemaker implanted. There were no complications resulting from the IRF ablation. All 15 patients survived over the average follow-up period of 24 months. Thirteen patients were still in sinus rhythm, 1 had pacemaker rhythm, and only 1 (1 of 15; 6.5{\%}) suffered a recurrence of atrial fibrillation 3 months after the procedure. Conclusions: We suggest adding intraoperative IRF ablation during surgical closure of an ASD in all adult ASD patients with arrhythmias. The IRF ablation is easy to perform, safe, and effective.",
author = "Alessandro Giamberti and Massimo Chessa and Sara Foresti and Raul Abella and Gianfranco Butera and {de Vincentiis}, Carlo and Mario Carminati and Lorenzo Menicanti and Alessandro Frigiola",
year = "2006",
month = "10",
doi = "10.1016/j.athoracsur.2006.05.010",
language = "English",
volume = "82",
pages = "1327--1331",
journal = "Annals of Thoracic Surgery",
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number = "4",

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TY - JOUR

T1 - Combined Atrial Septal Defect Surgical Closure and Irrigated Radiofrequency Ablation in Adult Patients

AU - Giamberti, Alessandro

AU - Chessa, Massimo

AU - Foresti, Sara

AU - Abella, Raul

AU - Butera, Gianfranco

AU - de Vincentiis, Carlo

AU - Carminati, Mario

AU - Menicanti, Lorenzo

AU - Frigiola, Alessandro

PY - 2006/10

Y1 - 2006/10

N2 - Background: Atrial arrhythmias are relatively common among patients over 40 years old with atrial septal defect (ASD) and are a precipitating cause of heart failure. Surgical closure of the ASD in these patients is feasible and is associated with a low mortality rate and a beneficial effect on the clinical status; however the occurrence of atrial arrhythmia does not decrease after surgery. We present the results of our preliminary experience with surgical ASD closure combined with intraoperative irrigated radiofrequency (IRF) ablation in adult patients. Methods: During a 26-month period between September 2002 and December 2004, 15 patients more than 40 years old with ASD and atrial arrhythmia underwent elective surgical closure of the defect and intraoperative IRF ablation. All patients had supraventricular arrhythmias: 8 had permanent atrial fibrillation, whereas 7 had previous episodes of atrial flutter or intra-atrial reentry tachycardia. The biatrial approach (Cox-Maze III procedure) was used in 7 patients and a right-sided Maze procedure (ablation lines on the right atrium only) was carried out in the remaining 8 patients. Results: All patients survived the procedure. Fourteen patients left the operating room in sinus rhythm and 1 had a pacemaker implanted. There were no complications resulting from the IRF ablation. All 15 patients survived over the average follow-up period of 24 months. Thirteen patients were still in sinus rhythm, 1 had pacemaker rhythm, and only 1 (1 of 15; 6.5%) suffered a recurrence of atrial fibrillation 3 months after the procedure. Conclusions: We suggest adding intraoperative IRF ablation during surgical closure of an ASD in all adult ASD patients with arrhythmias. The IRF ablation is easy to perform, safe, and effective.

AB - Background: Atrial arrhythmias are relatively common among patients over 40 years old with atrial septal defect (ASD) and are a precipitating cause of heart failure. Surgical closure of the ASD in these patients is feasible and is associated with a low mortality rate and a beneficial effect on the clinical status; however the occurrence of atrial arrhythmia does not decrease after surgery. We present the results of our preliminary experience with surgical ASD closure combined with intraoperative irrigated radiofrequency (IRF) ablation in adult patients. Methods: During a 26-month period between September 2002 and December 2004, 15 patients more than 40 years old with ASD and atrial arrhythmia underwent elective surgical closure of the defect and intraoperative IRF ablation. All patients had supraventricular arrhythmias: 8 had permanent atrial fibrillation, whereas 7 had previous episodes of atrial flutter or intra-atrial reentry tachycardia. The biatrial approach (Cox-Maze III procedure) was used in 7 patients and a right-sided Maze procedure (ablation lines on the right atrium only) was carried out in the remaining 8 patients. Results: All patients survived the procedure. Fourteen patients left the operating room in sinus rhythm and 1 had a pacemaker implanted. There were no complications resulting from the IRF ablation. All 15 patients survived over the average follow-up period of 24 months. Thirteen patients were still in sinus rhythm, 1 had pacemaker rhythm, and only 1 (1 of 15; 6.5%) suffered a recurrence of atrial fibrillation 3 months after the procedure. Conclusions: We suggest adding intraoperative IRF ablation during surgical closure of an ASD in all adult ASD patients with arrhythmias. The IRF ablation is easy to perform, safe, and effective.

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U2 - 10.1016/j.athoracsur.2006.05.010

DO - 10.1016/j.athoracsur.2006.05.010

M3 - Article

C2 - 16996928

AN - SCOPUS:33748751694

VL - 82

SP - 1327

EP - 1331

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -