tailieunhanh - Báo cáo y học: "Ablation of atrial fibrillation with the Epicor system: a prospective observational trial to evaluate safety and efficacy and predictors of success"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Ablation of atrial fibrillation with the Epicor system: a prospective observational trial to evaluate safety and efficacy and predictors of success. | Schopka et al. Journal of Cardiothoracic Surgery 2010 5 34 http content 5 1 34 Jdfrs JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Ablation of atrial fibrillation with the Epicor system a prospective observational trial to evaluate safety and efficacy and predictors of success Simon Schopka Christof Schmid Andreas Keyser Ariane Kortner Julia Tafelmeier Claudius Diez Leopold Rupprecht and Michael Hilker Abstract Background High intensity focused ultrasound HIFU energy has evolved as a new surgical tool to treat atrial fibrillation AF . We evaluated safety and efficacy of AF ablation with HIFU and analyzed predictors of success in a prospective clinical study. Methods From January 2007 to June 2008 110 patients with AF and concomitant open heart surgery were enrolled into the study. Main underlying heart diseases were aortic valve disease 50 ischemic heart disease 48 and mitral valve disease 18 . AF was paroxysmal in 29 persistent in 31 and long standing persistent in 40 of patients lasting for 1 to 240 months mean 24 months . Mean left atrial diameter was 50 7 mm. Each patient underwent left atrial ablation with the Epicor system prior to open heart surgery. After surgery the patients were treated with amiodarone and coumadin for 6 months. Follow-up studies including resting ECG 24 h Holter ECG and echocardiography were obtained at 6 and 12 months. Results All patients had successful application of the system on the beating heart prior to initiation of extracorporeal circulation. On average 11 1 ultrasound transducer elements were used to create the box lesion. The hand-held probe for additional linear lesions was employed in 83 cases. No device-related deaths occurred. Postoperative pacemaker insertion was necessary in 4 patients. At 6 months 62 of patients presented with sinus rhythm. No significant changes were noted at 12 months. Type of AF and a left atrial diameter 50 mm were predictors for failure of AF ablation.