Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery

Sinus rhythm restoration after thoracoscopic radiofrequency fragmentation of the left atrium

Authors: Vachev S.A. 1, Zotov A.S. 1, Stepanova M.A. 2, Surminova A.Yu. 2, Troitskiy A.V. 1, Khabazov R.I. 1

Company:
1 Federal Scientific Clinical Center Specialized Medical Care and Medical Technologies, Moscow, 115682, Russian Federation
2 State Health Institution Ulyanovsk Regional Clinical Hospital, Ul’yanovsk, 432017, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2020-17-2-99-106

UDC: 616.125.2-089.87-092.9:615.849

Link: Clinical Physiology of Blood Circulaiton. 2020; 17 (2): 99-106

Quote as: Vachev S.A., Zotov A.S., Stepanova M.A., Surminova A.Yu., Troitskiy A.V., Khabazov R.I. Sinus rhythm restoration after thoracoscopic radiofrequency fragmentation of the left atrium. Clinical Physiology of Circulation. 2020; 17 (2): 99–106 (in Russ.). DOI: 10.24022/1814-6910-2020-17-2-99-106

Received / Accepted:  30.01.2020/03.03.2020

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Abstract

Objective.To study the nature of the sinus rhythm restoration after thoracoscopic radiofrequency fragmentation of the left atrium (LA) in patients with non-paroxysmal forms of atrial fibrillation (AF).

Material and methods. The study included 48 consecutively operated patients. All of them had persistent or long-persistent form of AF. All patients underwent thoracoscopic radio frequency fragmentation of the LA using a same protocol of surgical procedure. The nature of the sinus rhythm restoration was analyzed depending on the duration of its absence before surgery, as well as depending on the intraoperative use of amiodarone.

Results. In 18 (37.5%) of patients, the sinus rhythm recovered on its own. A relationship was established between the form of AF and the nature of the restoration of the sinus rhythm (χ2=5.035, p=0.03; the strength of the relationship is relatively strong: normalized Pearson conjugation coefficient 0.436). The relationship between amiodarone infusion and the nature of the restoration of the sinus rhythm could not be established (χ2=0.64, p=0.4; the strength of the relationship is weak: normalized Pearson conjugation coefficient 0.162). Freedom from persistent recurrence of AF at follow-up up to 32 months after surgery was 96%.

Conclusion. Given that in the vast majority of patients (30 (62.5%)), the sinus rhythm was restored using electric pulse therapy, it should be noted that in the presence of a non-paroxysmal form of AF, one should not expect an self-restoration of the sinus rhythm after performing thoracoscopic radiofrequency fragmentation of the LA (p=0.02). We should not expect a decrease in the frequency of application of electric pulse therapy to restore sinus rhythm after surgery in patients with non-paroxysmal forms of AF with intraoperative use of the amiodarone infusion form (p=0.4). The criterion of “intraoperative self-restoration of the sinus rhythm” should not be used to assess the quality of performed thoracoscopic radiofrequency fragmentation of the LA.

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About Authors

  • Sergey A. Vachev, Cand. Med. Sc., Cardiovascular Surgeon; orcid.org/0000-0002-2747-3057
  • Aleksandr S. Zotov, Cand. Med. Sc., Cardiovascular Surgeon, Head of Cardiovascular Surgery Department; orcid.org/0000-0003-0494-0211
  • Margarita A. Stepanova, Cardiologist; orcid.org/0000-0002-5230-0510
  • Anna Yu. Surminova, Cardiologist, Head of Cardiology Department; orcid.org/0000-0001-9197-9223
  • Aleksandr V. Troitskiy, Dr. Med. Sc., Cardiovascular Surgeon, Chief Executive Officer; orcid.org/0000-0003-2143-8696
  • Robert I. Khabazov, Dr. Med. Sc., Cardiovascular Surgeon, Chief Physician; orcid.org/0000-0001-6801-6568

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