Comparison of uniatrial and biatrial radiofrequency ablation procedures in atrial fibrillation: initial results.

BACKGROUND: Atrial fibrillation (AF) is the most commonly sustained cardiac rhythm disturbance. Surgical ablation techniques were developed involving the left atrium only and modifications of the maze procedure in ablating both atria. OBJECTIVE: The aim of this study was to compare, in patients with permanent AF, the efficacy of uniatrial versus biatrial radiofrequency ablation procedure in the treatment of chronic atrial fibrillation in patients with associated cardiac disease. METHOD: Between September 2003 and May 2009, 30 patients were submitted to the radiofrequency ablation procedure for AF associated with concomitant cardiac surgery; 15 patients underwent a uniatrial procedure, and 15 patients underwent biatrial ablation. The mean age was 47.73 ± 9.85 years, and 53.4% were men. The average followup time was 12.16 ± 10.89 months for the uniatrial group and 7.0 ± 4.0 months for the biatrial group. RESULTS: Neither hospital mortality nor complications related to radiofrequency ablation were was registered. At the time of hospital discharge, 9 patients (60%) were in a state of sinus rhythm in both groups. However, patients undergoing biatrial ablation (range 73.3% versus 46.7%) demonstrated complete freedom from atrial fibrillation at all times. CONCLUSION: Biatrial ablation surgical procedures were more effective in controlling atrial fibrillation than procedures limited to the left atrium.