Abstract： Objective To summarize the clinical outcomes of maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of permanent atrial fibrillation（AF） and rheumatic valve diseases. Methods A total of 124 patients with permanent AF and rheumatic valves diseases undergoing surgical treatment from March 2006 to October 2010 in the First Affiliated Hospital of Sun Yat-sen University were randomly divided into ablation group and control group using coin method with 62 patients in each group. The mean atrial fibrillation duration was（56.1±47.1） months in ablation group, and patients in this group underwent maze procedure using bipolar radiofrequency ablation and valve replacement. The mean atrial fibrillation duration was（43.8±25.6） months in control group, and patients in this group underwent only valve replacement. Demographic characteristics, cardiopulmonary bypass（CPB）time, aortic cross-clamping（ACC）time, mechanical ventilation time, intensive care unit（ICU） length of stay, postoperative complications and follow-up outcomes were compared between the two groups. Results The demographic characteristics of the two groups were not statistically different （P＞0.05）. The CPB time and ACC time between the two groups were not statistically different （P＞ 0.05）. The postoperative hospital stay of ablation group was significantly longer than that of control group （15.8±6.1 d vs. 12.9±3.1d，P=0.001）. No patient needed permanent pacemaker implantation in either group. Postoperative ejection fraction of ablation group was significantly higher than that of control group（59.6%±9.2% vs. 55.5%±5.4%，P＜ 0.01）. The rate of sinus rhythm maintenance at 6 months, 12 months, 18 months, 24 months during follow-up in ablation group were 88.5%, 87.5%, 87.1% and 82.4% respectively, 3.3%, 2.2%, 0.0%, and 0.0% in control group respectively, which was statistically different between the two groups（P＜ 0.05）. Conclusion Maze procedure using bipolar radiofrequency ablation is an effective surgical procedure for the treatment of permanent atrial fibrillation.
ObjectiveTo evaluate the efficacy of bipolar radiofrequency ablation procedure for atrial fibrillation (AF) during the open-heart surgery. MethodsWe retrospectively analyzed the clinical data of 137 heart disease patients combined with AF (21 patients combined with left atrial thrombus) who underwent one-stage operation of open-heart surgery and bipolar radiofrequency ablation from May 2009 to June 2014. There were 61 males and 76 females at age of 35-73(48.3±11.6)years. The patients received amiodarone treatment for 6 months after surgery and regular follow-up. The sinus rhythm conversion rate, cardiac function before and after operation, survival rate after operation, the incidence of thromboembolism and other complications were recorded. ResultsThe average cardiopulmonary bypass time during operation was 122±38 min, the average aortic crossclamp time was 78±22 min, and the average radiofrequency ablation time was 20±4 min. The atrial fibrillation was successfully ablated in 130 patients on the same day of surgery with conversion rate of 94.9%. The atrial fibrillation was converted to sinus rhythm in 114 patients, and converted to junctional cardiac arrhythmia in 16 patients. Two patients died during the perioperative period with death rate of 1.5% in hospital. The conversion rate was 81.5% (110/135), 88.1% (111/126), 83.1% (74/89), and 83.0% (39/47) respectively at one month, six months, one year, and two years after surgery, respectively. The survival rate was 96.6% (86/89) and 93.6% (44/47) at one year and two years after surgery. No thromboembolism occurred during the long-term follow-up period. ConclusionBipolar radiofrequency ablation procedure selectively performed during open-heart surgery can cure atrial fibrillation, only increases cardiopulmonary bypass and aortic crossclamp time slightly. The short- and mid-term efficacy is satisfactory with high conversion rate of sinus rhythm. The long-term effect still needs further observation.
ObjectiveTo indirectly compare the efficacy and safety of bipolar radiofrequency ablation versus hysterectomy in abnormal uterine bleeding by using network meta-analysis. MethodsThe PubMed, EMbase, Web of Science, Cochrane Library, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of different surgical methods in abnormal uterine bleeding from inception to May 20, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 39 RCTs involving 3 307 patients were included. The results of network meta-analysis showed that hysterectomy was superior to bipolar radiofrequency ablation in terms of amenorrhea rate and reintervention rate, while the hospital stay and patient satisfaction rate were opposite. ConclusionCurrent evidence shows that bipolar radiofrequency ablation has more advantages in terms of hospital stay and satisfaction rate, while hysterectomy has more advantages in terms of amenorrhea rate and reintervention rate. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.