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Jönsson A, Lehto M, Ahn H, Hermansson U, Linde P, Ahlsson A, Koistinen J, Savola J, Raatikainen P, Lepojärvi M, Sahlman A, Werkkala K, Toivonen L, Walfridsson H. Microwave Ablation in Mitral Valve Surgery for Atrial Fibrillation (MAMA). J Atr Fibrillation 2012; 5:432. [PMID: 28496753 DOI: 10.4022/jafib.432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 02/27/2012] [Accepted: 02/27/2012] [Indexed: 11/10/2022]
Abstract
Objective: Microwave ablation in conjunction with open heart surgery is effective in restoring sinus rhythm (SR) in patients with atrial fibrillation (AF). In patients assigned for isolated mitral valve surgery no prospective randomized trial has reported its efficacy. Methods: 70 patients with longlasting AF where included from 5 different centres. They were randomly assigned to mitral valve surgery and atrial microwave ablation or mitral valve surgery alone. Results: Out of 70 randomized, 66 and 64 patients were available for evaluation at 6 and 12 months. At 12 months SR was restored and preserved in 71.0 % in the ablation group vs 36.4 % in the control group (P=0.006), corresponding figures at 6 months was 62.5 % vs 26.5 % (P=0.003). The 30-day mortality rate was 1.4 %, with one death in the ablation group vs zero deaths in the control group. At 12 months the mortality rate was 7,1 % (Ablation n=3 vs Control n=2). No significant differences existed between the groups with regard to the overall rate of serious adverse events (SAE) during the perioperative period or at the end of the study. 16 % of patients randomized to ablation were on antiarrhytmic drugs compared to 6 % in the control group after 1 year (p=0.22). Conclusion: Microwave ablation of left and right atrium in conjunction with mitral valve surgery is safe and effectively restores sinus rhythm in patients with longlasting AF as compared to mitral valve surgery alone.
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Affiliation(s)
- Anders Jönsson
- Department of Cardiology, Linnköping University Hospital, Linnköping, Sweden
| | - Mika Lehto
- Department of Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - Henrik Ahn
- Department of Cardiothoracic Surgery, Linnköping University Hospital, Linnköping, Sweden
| | - Ulf Hermansson
- Department of Cardiothoracic Surgery, Linnköping University Hospital, Linnköping, Sweden
| | - Peter Linde
- Department of Cardiology, Örebro University Hospital, Örebro, Sweden
| | - Anders Ahlsson
- Department of Cardiothoracic Surgery, Örebro University Hospital, Örebro, Sweden
| | - Juhani Koistinen
- Department of Cardiology, Turku University Hospital, Turku, Finland
| | - Jukka Savola
- Department of Cardiothoracic Surgery, Turku University Hospital, Turku, Finland
| | | | - Martti Lepojärvi
- Department of Cardiothoracic Surgery, Oulu University Hospital, Oulu, Finland
| | - Antero Sahlman
- Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Kalervo Werkkala
- Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Lauri Toivonen
- Department of Cardiology, Helsinki University Hospital, Helsinki, Finland
| | - Håkan Walfridsson
- Department of Cardiology, Linnköping University Hospital, Linnköping, Sweden
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