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5-year long-term results of MCG map-guide minimal AF surgery in long-standing persistent AF patients
Doosang Kim.
Seoul Veterans Hospital, Seoul, Korea, Republic of.

OBJECTIVE: Map-guided AF surgery will be a good help to treat AF successfully. We introduced the magnetocardiography action potential activity mapping, non-contact and higher sensitive method to detect atrial F-wave for tracing abnormal conduction route than conventional EKG. Using this method, we conducted the MCG map-guide minimal AF surgery and report their 5-year long-term results.
METHODS: To detect weak atrial excitation, we utilized a high sensitive low-Tc 64-channel MCG system with application software KRISSMCG64 to make a MCG map on the three-dimensional atrial surface. From the information of MCG map, from 2006 June to 2008 June, we conducted the minimal AF surgery in 8 long-standing persistent AF patients having concomitant structural heart disease, such as valvular or coronary disease. Their mean age is 63 years old, AF duration is 17 months, AF burden is 1.0, LA size is 60 mm, LVEF is 54 %. Monthly-based standard 12-lead ECG was used for follow-up examination.
RESULTS: Among the 8 long-standing persistent AF patients who had underwent MCG map-guide minimal AF surgery, there are two early loss patients due to CRF sepsis and CVA stroke (at 21 and 15 postoperative days, respectively) and two follow-up loss patients because of pneumonia (at 25.3 and 5.7 months, respectively). The remaining 4 patients show 100% (4/4) regular QRS rhythm with varying atrial contraction activities at 72.2, 68.0, 61.4 and 59.5 months follow-up periods (mean follow-up 65.3months, 5.4years). Their final atrial contraction activities are Normal Sinus P, AT 2:1 conduction, and atrial irregular contraction. There are no thrombo-embolic episode, sick sinus syndrome, no permanent pacemaker insertion cases.
CONCLUSIONS: Using MCG map-guide, we conducted minimal AF surgery in the patients who has long-standing persistent AF, and their 5-year long-term rhythms converted all regular AF-free rhythm successfully with drug-off status. It is a good method to treat AF with long-term feasible results.


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