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Ezzeldin A Mostafa

Ezzeldin A Mostafa

Ain Shams University Hospital, Egypt

Title: Comparative study between two devices of radio-frequency energy for bi-atrial maze operation for the treatment of long-standing atrial fibrillation: Prospective randomized trial

Biography

Biography: Ezzeldin A Mostafa

Abstract

Background & Aim: The Electro Surgical Unit (ESU or Bovie) is a Radio Frequency (RF) generator and can be used to create surgical lesions, which cause interruption of the basic flutter cycle that initiates/maintains chronic permanent Atrial Fibrillation (AFib). The aim of the study is to evaluate the efficacy and efficiency of the bi-atrial electro-maze plus amiodarone in the management of chronic permanent AFib in mitral valve surgery and to compare between two sources of RF energy;
namely, ESU or bovie and RF devices.
Method: After approval of Local Ethics Committee and obtaining written informed consent, a prospective, comparative randomized study was conducted on 90 patients who were referred for mitral valve surgery with chronic AFib. They were divided into three groups. Group-1: 30 patients were submitted to bi-atrial RF maze and amiodarone protocol. Group-2: 30 patients were submitted to bi-atrial ESU or bovie maze and amiodarone protocol. Group-3: 30 patients were treated with amiodarone only. Patients were followed-up in the post-operative period at the following time intervals, 2 weeks, 3 months and 6 months.
Results: There was no mortality in any group. The aortic-cross clamp time, bypass time were slightly longer in the electro-maze groups, but without any statistical signifi cance. There was no statistical significance amongst the 3 groups as regard morbidity. There was an immediate intraoperative conversion to sinus rhythm in the 3 groups respectively (83.3%, 80% and 20%). Sinus rhythm has remained stable over 3-month duration in the 3 groups respectively (70%, 66.6% and 16.6%) and over a follow-up of 6-month duration (66.6%, 63.3% and 13.3%). In the electro-maze groups, there has been a signifi cant reduction in left atrial size.
Conclusion: The bi-atrial electro-maze protocol appears to be a simple, effective, and quick method to cure chronic permanent AFib. The ESU or bovie is as effective as radiofrequency device as a source of energy for ablation.