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Introduction: Pulmonary veins isolation (PVI) is useful method in patients (pts) with mitral valve disease (MVD) and chronic atrial fibrillation (AF) during prosthetic valve implantation. The aim of the study: To evaluate e.ectiveness of PVI in the treatment of AF in pt with MVD during valve implantation. Material and methods: 45 pts (mean age 55 yrs) with AF were operated on for MVD.RF ablation around the pulmonary veins, a lesion between them and to the mitral annulus were performed. There were 44 prostheses implanted, 1 case of mitral valve annuloplasty, associated with tricuspid valve repair (5 pts), aorto-coronary bypass procedure (2 pts), ASD II closure (1 pt). Results: SR was achieved in 2 (44,5%) pts, 21 (46,5%)pts were in AF, 4 (9%) pts needed pacing. No correlation between SR restoration and preoperative echocardiographic parameters, age, gender, NYHA functional class were found. In long-term follow-up 1 pt have reversed AF to SR spontaneously. There were 6 cases of paroxysmal AF,1 pt needed pacemaker implantation. 20 (44,5%) pts are in SR, 20 (44,5%) in AF, 5 (11%) in permanent pacing. Conclusion: PVI with RF use is effective in restoring sinus rhythm in patients with chronic AF secondary to mitral valve disease.
EN
The pulmonary vein isolation remains the major target of atrial fibrillation ablation. The cryoablation lesions in the left atrium are supposed to disconnect the pulmonary vein from the atrium on the atrial side of the orifices. We hypothesized that the cryoballoon pulmonary vein isolation could result in the prolongation of the P wave duration. The aim of the study was to assess the duration of the P wave in 12-lead electrocardiogram and the influence of pulmonary vein isolation on this parameter. The study group included 21 patients (11 women and 10 men) 66.2+/-7.4 years of age undergoing cryoballoon ablation. In order to measure the P wave duration, we used the constant acquisition of electrogram and the electrocardiographic channels provided by LABSYSTEM™ Pro EP Recording System (Boston Scientific), magnifying the leads 64x. We calculated the duration in the simultaneously recorded 12-lead ECG, from the beginning of the earliest recorded P wave deflection, until the end of the latest P-wave deflection recorded in any lead. The P wave duration in the entire study group was 141.7+/-12.5 ms before the ablation and increased significantly to 151.1+/-11.5 ms (p<0.05) after the procedure. The respective values in women were 144.1+/-4.3 vs. 156.0+/-4.7 ms (p<0.01) and 139.1+/-4.6 vs. 145.6+/-4.5 ms in men (p<0.05). The mean standard deviation of every single measurement considered separately was 4.4+/-2.1 ms before the cryoablation and 4.6+/-1.8 ms after the procedure (p= not significant (n.s).), indicating very good reproducibility of the measurements. We concluded, that cryoballoon pulmonary vein isolation leads to the prolongation of the measured P wave duration. It seemed to result from conduction disturbances created by cryoablation. The clinical significance of the observed changes remains unknown.
EN
The pulmonary vein isolation remains the major target of atrial fibrillation ablation. The cryoablation lesions in the left atrium are supposed to disconnect the pulmonary vein from the atrium on the atrial side of the orifices. We hypothesized that the cryoballoon pulmonary vein isolation could result in the prolongation of the P wave duration. The aim of the study was to assess the duration of the P wave in 12-lead electrocardiogram and the influence of pulmonary vein isolation on this parameter. The study group included 21 patients (11 women and 10 men) 66.2+/-7.4 years of age undergoing cryoballoon ablation. In order to measure the P wave duration, we used the constant acquisition of electrogram and the electrocardiographic channels provided by LABSYSTEM™ Pro EP Recording System (Boston Scientific), magnifying the leads 64x. We calculated the duration in the simultaneously recorded 12-lead ECG, from the beginning of the earliest recorded P wave deflection, until the end of the latest P-wave deflection recorded in any lead. The P wave duration in the entire study group was 141.7+/-12.5 ms before the ablation and increased significantly to 151.1+/-11.5 ms (p<0.05) after the procedure. The respective values in women were 144.1+/-4.3 vs. 156.0+/-4.7 ms (p<0.01) and 139.1+/-4.6 vs. 145.6+/-4.5 ms in men (p<0.05). The mean standard deviation of every single measurement considered separately was 4.4+/-2.1 ms before the cryoablation and 4.6+/-1.8 ms after the procedure (p= not significant (n.s).), indicating very good reproducibility of the measurements. We concluded, that cryoballoon pulmonary vein isolation leads to the prolongation of the measured P wave duration. It seemed to result from conduction disturbances created by cryoablation. The clinical significance of the observed changes remains unknown.
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