A new procedure for elimination of atrial fibrillation associated with mitral valve disease: a proof-of-concept study

Author:

Chen Liangwan,Li Qianzhen,Chen Junyi,Qiu Zhihuang,Xiao Jun,Tang Mirong,Wu Qingsong,Shen Yue,Dai Xiaofu,Fang Guanhua,Lu Heng

Abstract

Background: Left atrial enlargement and fibrosis have been linked to the pathogenesis of atrial fibrillation (AF). The authors aimed to introduce a novel concept and develop a new procedure for AF treatment based on these characteristics. Methods: The study included three stages. The first stage was a descriptive study to clarify the characteristics of the left atrial enlargement and fibrosis’ distribution in patients with mitral valve disease and long-standing persistent AF. Based on these characteristics, the authors introduced a novel concept for AF treatment, and then translated it into a new procedure. The second stage was a proof-of-concept study with this new procedure. The third stage was a comparative effectiveness research to compare the clinical outcomes between patients with this new procedure and those who received Cox-Maze IV treatment. Results: Based on the nonuniform fashion of left atrial enlargement and fibrosis’ distribution, the authors introduced a novel concept: reconstructing a left atrium with appropriate geometry and uniform fibrosis’ distribution for proper cardiac conduction, and translated it into a new procedure: left atrial geometric volume reduction combined with left appendage base closure. As compared to the Cox-Maze IV procedure, the new procedure spent significantly shorter total surgery time, cardiopulmonary bypass time, and aortic cross-clamp time (P<0.001). Besides, the new procedure was related to a shorter ICU stay period (odd ratio (OR)=0.45, 95% CI=0.26–0.78), lower costs (OR=0.15, 95% CI=0.08–0.29), and a higher rate of A wave of transmitral and transtricuspid flow reappearance (OR=1.76, 95% CI=1.02–3.04). Conclusions: The new procedure is safe and effective for eliminating AF associated with mitral valve disease.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3