Marty
Well-known member
All too often patients after mitral valve repair or replacement fibrillate and must take Coumadin even if their surgeon used a tissue valve to avoid it. I have a very good young friend who had a good repair but is on Coumadin and amiodarone. The pasted article is an attempt to avoid this.
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Radiofrequency ablation during mitral valve surgery helps restore sinus rhythm
11/10/2005
By: Reuters Health
NEW YORK (Reuters Health), No 10 - Radiofrequency ablation (RFA) of the left atrium during mitral valve surgery can increase the likelihood of restoring sinus rhythm in patients with continuous atrial fibrillation, according to a report in the Journal of the American Medical Association for November 9. This translates into an improved exercise capacity.
The findings are based on a study of 97 patients who were referred for mitral valve surgery and had continuous atrial fibrillation for at least six months. The subjects were randomized to undergo the operation alone or in combination with RFA of the left atrium.
At one-year follow-up, sinus rhythm was noted in 44.4% of RFA-treated patients compared with just 4.5% of controls, lead author Dr. George Doukas, from Glenfield Hospital in Leicester, U.K., and colleagues note. Thus, RFA raised the likelihood of sinus rhythm restoration by nearly tenfold.
Restoration of sinus rhythm in the RFA group nearly doubled the mean shuttle-walk distance compared with that seen in controls, the authors note. In addition, the RFA-induced return to sinus rhythm was linked to a greater drop in plasma levels of B-type natriuretic peptide (p = 0.03).
No significant differences in postoperative complications and deaths were seen between the groups, the investigators point out.
"Our findings suggest that routine use of left atrial RFA during mitral valve surgery is justified," the researchers conclude.
In a related editorial, Dr. Thoralf M. Sundt and Dr. Bernard J. Gersh, from the Mayo Clinic in Rochester, Minnesota, comment that "whether attempts to maintain sinus rhythm will translate into meaningful clinical benefit remains to be determined. The logic that sinus rhythm is preferable is obvious but the burden of proof remains."
Last Updated: 2005-11-09 14:05:38 -0400 (Reuters Health)
JAMA 2005;294:2323-2329,2357-2359.
Copyright © 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
--------------------------------------------------------------------------------
Radiofrequency ablation during mitral valve surgery helps restore sinus rhythm
11/10/2005
By: Reuters Health
NEW YORK (Reuters Health), No 10 - Radiofrequency ablation (RFA) of the left atrium during mitral valve surgery can increase the likelihood of restoring sinus rhythm in patients with continuous atrial fibrillation, according to a report in the Journal of the American Medical Association for November 9. This translates into an improved exercise capacity.
The findings are based on a study of 97 patients who were referred for mitral valve surgery and had continuous atrial fibrillation for at least six months. The subjects were randomized to undergo the operation alone or in combination with RFA of the left atrium.
At one-year follow-up, sinus rhythm was noted in 44.4% of RFA-treated patients compared with just 4.5% of controls, lead author Dr. George Doukas, from Glenfield Hospital in Leicester, U.K., and colleagues note. Thus, RFA raised the likelihood of sinus rhythm restoration by nearly tenfold.
Restoration of sinus rhythm in the RFA group nearly doubled the mean shuttle-walk distance compared with that seen in controls, the authors note. In addition, the RFA-induced return to sinus rhythm was linked to a greater drop in plasma levels of B-type natriuretic peptide (p = 0.03).
No significant differences in postoperative complications and deaths were seen between the groups, the investigators point out.
"Our findings suggest that routine use of left atrial RFA during mitral valve surgery is justified," the researchers conclude.
In a related editorial, Dr. Thoralf M. Sundt and Dr. Bernard J. Gersh, from the Mayo Clinic in Rochester, Minnesota, comment that "whether attempts to maintain sinus rhythm will translate into meaningful clinical benefit remains to be determined. The logic that sinus rhythm is preferable is obvious but the burden of proof remains."
Last Updated: 2005-11-09 14:05:38 -0400 (Reuters Health)
JAMA 2005;294:2323-2329,2357-2359.
Copyright © 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
