Abstract
Aim. Ablation of atrial arrhythmias after surgical ablation for atrial fibrillation remains challenging. The aim of our study was to assess electrophysiological characteristics of left atrial postablational arrhythmias occurred in patients after modified maze procedure (maze-IIIB) according to L.A. Bockeria.
Material and methods. Eight patients were included into the study. These patients previously underwent surgical ablation for atrial fibrillation according to L.A. Bockeria and concomitant treatment of acquired heart defects. All catheter ablation procedures were performed using 3D navigation system CARTO XP Verification of the tachycardia isthmuses was made with entrainment pacing.
Results. Totally 8 postablational arrhythmia cycles were identified. Perimitral flutter was diagnosed in 2 (25%) patients, ectopic atrial tachyacrdias — in 2 (25%) patients, atrial tachycardias around left pulmonary veins — in 2 (25%) patients. The latter tachycardias were successfully ablated at the left atrial roof. In 2 remaining patients we could not perform transseptal puncture due to the scar in the interatrial septum after open heart surgery. In these patients during electrophysiological study fragmented activity in the coronary sinus was revealed. Entrainment pacing allowed verification of left atrial tachycardias.
Conclusion. Surgical ablation for atrial fibrillation performed in isolation or in combination with other heart surgical procedures becomes routine in everyday cardiosurgical clinical practice. In some patients secondary arrhythmias are developed. These atrial arrhythmias could be successfully cured with catheter ablation that allows to increase total efficacy of surgical treatment of atrial fibrillation.
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About the authors
- Sergeev Aleksey Viktorovich, Cand. Med. Sc., Researcher, orcid.org/0000-0002-2949-3238;
- Bockeria Ol'ga Leonidovna, Dr. Med. Sc., Professor, Corresponding Member of Russian Academy of Sciences, Chief Researcher, orcid.org/0000-0002-7711-8520;
- Melikulov Aziz Kholmuradovich, Dr. Med. Sc., Head of Laboratory, orcid.org/0000-0001-5103-3011;
- Klimchuk Igor' Yaroslavovich, Junior Researcher; Turdubaev Abay Kubanychbekovich, Postgraduate;
- Bockeria Leo Antonovich, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director, orcid.org/ 0000-0002-6180-2619
