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Long-term follow-up after endocardial radiofrequency modified Nitta procedure for concomitant atrial fibrillation treatment

Department of Cardiac Surgery, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium

*Corresponding author. Moorselbaan 164, 9300 Aalst, Belgium. Tel.: +32-477-485546; fax: +32-53-724552.

E-mail address: beloumei{at}ulb.ac.be (B. El Oumeiri).

In atrial fibrillation (AF) patients, the surgical restoration of sinus rhythm aims at restoring atrial contraction, hence to decrease thromboembolic events. We investigated the long-term outcome of radiofrequency (RF) ablation by a modified Nitta procedure, in patients with AF associated with operative structural heart diseases. Between September 2000 and April 2004, a total of 20 patients (63.7±13.34 years) with structural heart diseases due to surgery and chronic AF underwent endocardial RF ablation. Evaluation was achieved at discharge, at 6 months, 12 months and in November 2005. Echocardiography, 12-derivations electrocardiogram and 24-h electrocardiogram were obtained. At the mean follow-up of 43.25±13.4 months, 14 out of 20 patients (70%) were in sinus rhythm. Actuarial freedom from AF recurrence was 85% after 6 months, 75% after 12 months and 70% at the follow-up completion. Effective atrial contraction was present in 78.5% of patients with sinus rhythm. No hemodynamic pulmonary edema has been reported during the hospital stay, and no thromboembolic event has been reported during the follow-up period. The Nitta procedure, modified for RF ablation, is an easy procedure when performed in the setting of structural heart disease surgery. Further studies are warranted to evaluate this technique on a larger scale basis.

Key Words: Atrial fibrillation; Mitral valve disease; Radiofrequency