Radiofrequency Ablation in Patients Undergoing Mitral Valve Surgery with or without Giant Left Atria

Ye, Qing; Zhao, Yichen; Liu, Kemin; Zhao, Cheng; Liu, Yang; Li, Yuqi; Wang, Jiangang

doi:10.5761/atcs.oa.22-00033

ATCS

2022

DOI: 10.5761/atcs.oa.22-00033

|View full text |Cite

Radiofrequency Ablation in Patients Undergoing Mitral Valve Surgery with or without Giant Left Atria

Qing Ye

Yichen Zhao

Kemin Liu

et al.

Abstract: Purpose: We aimed to compare the efficacy of radiofrequency ablation (RFA) in patients undergoing mitral valve (MV) surgery with or without giant left atria. Methods: This retrospective, single-center, cohort study investigated patients who underwent MV surgery and concomitant RFA from 2009 to 2019. Patients were divided into non-giant left atria (diameter ≤65 mm, n = 1543) and giant left atria (diameter >65 mm, n = 241) groups. Five-year freedom from atrial tachyarrhythmia recurrence and thromboembolic event … Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2022

2024

Publication Types

Select...

Article3

Relationship

Self Cite0

Independent3

Authors

Journals

Cited by 3 publications

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Outcome of mitral repair combined with Cox-maze procedure for atrial functional mitral regurgitation with heart failure with recovered ejection fraction

Zhao

Bai

et al. 2023

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

OBJECTIVE Atrial functional mitral regurgitation (AFMR) in patients with heart failure with recovered ejection fraction (HFrecEF) has received insufficient attention. This study analysed the prognosis and outcomes of mitral valve (MV) repair combined with the Cox-maze procedure. METHODS A prospective cohort study of patients with AFMR with left ventricular ejection fraction (LVEF) <40% was conducted. All patients received guideline-directed medical therapy (GDMT). Those with recovered ejection fraction underwent MV repair combined with the Cox-maze procedure. Mortality, atrial fibrillation (AF) recurrence, mitral regurgitation (MR), and postoperative tricuspid regurgitation were assessed using the inverse probability weighting (IPW) method. RESULTS In total, 312 patients were enrolled in this study between 2010 and 2019, 247 of whom underwent MV repair combined with the Cox-maze procedure [full recovery (LVEF > 50%): n = 132, partial recovery (LVEF of 40–50%): n = 115]. IPW-adjusted survival of patients with LVEF ≥ 50% and LVEF of 40–50% showed no significant difference [hazard ratio (HR): 2.18, 95% confidence interval (CI): 0.46–10.38, P = 0.33]. However, patients with LVEF ≥50% had better IPW-adjusted long-term freedom from recurrent MR [HR: 2.44 (1.28–4.63), P = 0.0065] and AF recurrence [HR: 1.85 (1.06–3.21), P = 0.030] than those with LVEF of 40–50%. CONCLUSIONS MV repair combined with the Cox-maze procedure was effective and feasible in patients with severe AFMR with HFrecEF. Additionally, patients with LVEF ≥ 50% after GDMT undergoing these combined procedures had better long-term freedom from recurrent AF and MR than those with LVEF of 40–50%.

show abstract

Outcome of mitral repair combined with Cox-maze procedure for atrial functional mitral regurgitation with heart failure with recovered ejection fraction

Zhao

Bai

et al. 2023

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

Catheter Ablation or Surgical Therapy in Severe Atrial Functional Mitral Regurgitation Caused by Long‐Standing Persistent Atrial Fibrillation—Propensity Score Analysis

Ye,

Li,

Zhang

et al. 2024

JAHA

View full text Add to dashboard Cite

Background There is no consensus on the treatment strategy for patients with severe atrial functional mitral regurgitation combined with heart failure (HF), with a lack of comparative studies in patients with long‐standing persistent atrial fibrillation and severe atrial functional mitral regurgitation. We aim to compare mitral valve repair combined with the maze procedure with catheter ablation in patients with severe atrial functional mitral regurgitation due to long‐standing persistent atrial fibrillation. Methods and Results Patients with severe atrial functional mitral regurgitation and long‐standing persistent atrial fibrillation were included in this retrospective cohort study. Surgical patients underwent mitral valve repair combined with the Cox maze procedure, whereas catheter patients underwent catheter radiofrequency ablation. Mortality, atrial fibrillation recurrence, and HF readmission were assessed using overlap propensity score weighting. Then, between 2018 and 2022, we identified 302 patients: 215 in the surgical group and 87 in the catheter group. There were significant differences in the baseline characteristics between groups. The surgical group had lower rates of atrial fibrillation recurrence ( P =0.03), HF readmission ( P =0.03), and mitral regurgitation grade >2 at discharge ( P <0.01) and follow‐up ( P <0.01). However, there were no significant differences in the 5‐year freedom from death (log‐rank P =0.87), atrial fibrillation recurrence (log‐rank P =0.36), or HF readmission rates (log‐rank P =0.18). Conclusions Compared with surgical patients, the catheter group had higher atrial fibrillation recurrence and HF readmission rates; however, the difference was not significant after overlap propensity score weighting. Although the proportion of patients with significant mitral regurgitation at the last follow‐up was higher after catheter ablation, most patients still showed an effective decrease in mitral regurgitation severity.

show abstract

Clinical effect of total thoracoscopic mitral valve surgery combined with atrial fibrillation radiofrequency ablation in patients with different left atrium diameter—a single center prospective observational cohort study

Yao¹,

Zhang²,

Li³

et al. 2022

J Thorac Dis

View full text Add to dashboard Cite

Background Mitral valve surgery combined with atrial fibrillation (AF) radiofrequency ablation (AFRA) is recommended as the first-line strategy for valvular disease-related AF. There are relatively few reports on the effect of AFRA combined with total thoracoscopic mitral valve surgery. This article aimed to analyze the clinical data and prognostic outcomes of patients with diverse left atrium diameter (LAD) (>50 or ≤50 mm) who underwent total thoracoscopic mitral valve surgery combined with AFRA. Methods We conducted a prospective analysis of patients who underwent AFRA from January 2021 to June 2022 in the Department of Cardiovascular Surgery at the Chinese PLA General Hospital. The inclusion criteria were: (I) aged 40–70 years; (II) diagnosed with valvular heart disease and concomitant long-term persistent AF (>1 year); (III) patients who underwent total thoracoscopic mitral valve surgery; (IV) with a left ventricular end-diastolic diameter of ≤70 mm; (V) with a LAD ≤65 mm; and (VI) left ventricular ejection fraction (LVEF) ≥50%. The included patients were assigned to group A and B depend up on the LAD. All patients were followed up at 3 and 6 months timepoints postoperatively. The prime endpoint was the recovery rate of sinus rhythm. Results There were 24 cases in group A (LAD >50 mm) and 16 cases in group B (LAD ≤50 mm). The two groups exhibited no statistical differences in terms of age, gender proportion, preoperative comorbidities, AF duration, preoperative heart function, and type of valve disease (P>0.05). The LAD, pulmonary artery pressure, and left ventricular diameter of group A were significantly greater than those of group B (P<0.05). There were no new cerebrovascular incidents during the perioperative and follow-up periods. The sinus rhythm conversion rates in group A after surgery and at 6 months were 75% and 66.7%, respectively; meanwhile, both of these values were 87.5% in group B, and the difference between the groups was statistically significant (P<0.05). Conclusions Total thoracoscopic mitral valve surgery with AFRA is more effective in maintaining sinus rhythm in patients with LAD ≤50 mm than in those with LAD >50 mm without increased risk of adverse events. Further studies are warranted to validate our findings.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Radiofrequency Ablation in Patients Undergoing Mitral Valve Surgery with or without Giant Left Atria

Cited by 3 publications

References 26 publications

Outcome of mitral repair combined with Cox-maze procedure for atrial functional mitral regurgitation with heart failure with recovered ejection fraction

Outcome of mitral repair combined with Cox-maze procedure for atrial functional mitral regurgitation with heart failure with recovered ejection fraction

Catheter Ablation or Surgical Therapy in Severe Atrial Functional Mitral Regurgitation Caused by Long‐Standing Persistent Atrial Fibrillation—Propensity Score Analysis

Clinical effect of total thoracoscopic mitral valve surgery combined with atrial fibrillation radiofrequency ablation in patients with different left atrium diameter—a single center prospective observational cohort study

Contact Info

Product

Resources

About