Atrial Fibrillation Clinical Trial
Official title:
Bipolar Radiofrequency Ablation Plus Endocardial Ablation Using Argon Beam Coagulator for Atrial Fibrillation Treatment in Patients With Rheumatic Heart Disease
The objective of the study is to make up the technique blind spots of the bipolar radiofrequency ablation in the surgical treatment of atrial fibrillation with rheumatic heart disease by using argon beam coagulator. And to improve the rates of cardioversion of atrial fibrillation after surgery, to decrease the long-term recurrence rate of atrial fibrillation and to compare the early term and long term outcomes of bipolar radiofrequency ablation and bipolar radiofrequency plus argon beam coagulator ablation.
Atrial fibrillation(AF) is the most common sustained arrhythmia. It can cause reduced heart
function and increase the risk of thromboembolism. About 60% of patients with rheumatic
heart disease have persistent AF.AF surgery is an effective intervention for patients with
all types of AF undergoing concomitant cardiac surgery. AF surgery can reduce the risks of
heart of stroke and heart failure and promote longer survival. Bipolar radiofrequency
ablation is one of the most effective ways. But in the investigators' early study we find
that there are technique blind spots in the left atrial ablation and right atrial ablation.
In the bipolar left atrial linear ablation performed along the lower edge of interatrial
groove incision up to the mitral annulus, there is a gap between the ends of the ablation
line to the mitral annulus. And if the investigators use bipolar radiofrequency pliers it
may injure the lcx left circumflex artery and left ventricular. In the bipolar right atrial
radiofrequency ablation, the linear ablation performed along the lower edge of the coronary
sinus ostium up to the inferoseptal commissure and the linear performed through the vertical
incision on anterior wall of the right atrium up to the tricuspid annulus, there is also a
gap between the end of the end of the ablation line and the tricuspid annulus. These gaps
are one of factors of the recurrence of AF.
Argon beam coagulator is one of the most common hemostasis tools in heart surgery. It can
also cause coagulation necrosis of the myocardium and do not do harm to the nearly
myocardium the same as bipolar radiofrequency ablation. In the investigators' early study
the investigators use the coagulation de plasma argon to burn the endocardium. And in the
investigators' 6 mouth follow up, the rate of cardioversion is 90%. In this study the
investigators plan to use argon beam coagulator to ablate these gaps.
The objective of the study is to make up the technique blind spots of the bipolar
radiofrequency ablation in the surgical treatment of atrial fibrillation with rheumatic
heart disease by using argon beam coagulator. And to improve the rates of cardioversion of
atrial fibrillation after surgery, to decrease the long-term recurrence rate of atrial
fibrillation and to compare the early term and long term outcomes of bipolar radiofrequency
ablation and bipolar radiofrequency plusargon beam coagulator ablation.
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