Surgical treatment of permanent atrial fibrillation during heart valve surgery.

A simple strategy to abolish permanent atrial fibrillation (AF) in patients undergoing heart valve surgery is described. The concept includes: (1) endocardial radiofrequency (RF) ablation creating two encircling isolation lesions around the left and the right pulmonary veins (LPV, RPV) and a connection line between both; (2) antiarrhythmic protection with amiodarone for 3 months. Between 02/01 and 02/02 29 patients underwent surgical AF ablation procedures associated with primary valve operations (mitral, n=22; aortic, n=6; aortic+mitral, n=1). Six months after surgery 87.5% (14 of 16) were in sinus rhythm (SR), particularly all patients with an LA diameter of <56 mm had SR.