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Irrigated radiofrequency ablation is a safe and effective technique to treat chronic atrial fibrillation

^a Department of Cardiothoracic Surgery, Berufsgenossenschaftliche Kliniken Bergmannsheil-University Hospital, Bochum, Germany
^b Department of Cardiology, Berufsgenossenschaftliche Kliniken Bergmannsheil-University Hospital, Bochum, Germany

^* Corresponding author. Tel.: +49-234-3026006; fax: +49-234-3026010
krishna.khargi{at}ruhr-uni-bochum.de

Objective: The safety of intraoperative non-irrigated temperature-controlled radiofrequency ablation to treat atrial fibrillation is a matter of debate. This study evaluates a different operative technique using saline-irrigated-cooled-tip radiofrequency ablation (SICTRA) to treat atrial fibrillation. Patients and methods: One hundred and twenty-four concomitant anti-arrhythmic procedures, using SICTRA were performed; 113 to treat chronic AF (>6 months) and 11 to cure paroxysmal AF. Results: Twenty-eight MVP, 42 MVR, 17 AVR and six double valve procedures with or without CABG, one ASD closure and 30 solitary CABG were performed. The mean (S.D.) left atrial diameter, preoperative duration of AF, aortic cross-clamp time were 50.5 mm (9.8), 57 months (64) and 99 min (21). Thirty day mortality was 4.8% (6/124; euroscore 17, 11, 8, 8, 6, 5). Autopsies did not reveal any esophageal, pulmonary orifice, or circumflex artery injuries. No ablation related bleeding was observed. Mean follow-up (S.D.) was 19.7 months (14.4). Fourteen patients died during follow-up. The cumulative postoperative SR at 6 and 12 months was 60% and 70%. The cumulative survival at 1 and 2 years was 86% and 83%. Conclusion: Irrigated radiofrequency ablation was effective. It was not associated with procedural complications in our series.

Key Words: Arrhythmia; Electrophysiology; Radiofrequency ablation; Atrial fibrillation; Esophageal injury; Circumflex artery injury; Mitral valve surgery; CABG

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