SURGICAL TREATMENT OF ATRIAL FIBRILLATION-Evaluation of card iac and hemodynamic effects for atrial isolation procedure

房颤是临床上最常见的心律失常。房颤的发展会导致三种不利的后遗症：1)心律不齐，2)心脏血流动力学受损，主要是因为失去了同步的心房跳动，以及3)血栓栓塞症的易感性增加。慢性房颤患者将经历相关的血栓栓塞性上皮细胞。1988年，Harada发展了右心房隔离术，该手术具有电生理效果，既能隔离房颤起始处的右心房，又能保留窦房结与心脏其余部分的正常功能和连续性。本研究的目的是评价心功能和血流动力学效应，并将该手术安全地应用于房颤患者。术后平均心房压、每搏输出量指数、左房压、右房压、Emax等指标与术前相比无明显变化，仍在正常范围内。根据这些结果，该手术应用于两例房颤和房间隔缺损患者。术后恢复正常窦性心律10个月，房颤消失。我们的结论是，本研究的目的是通过这些结果来实现的。

Atrial fibrillation is the most common arrhythmia noted in clinical practice. Three detrimental sequelae result from the development of atrial fibrillation: 1)an irregular heartbeat, 2)impaired cardiac hemodynamics, primarily because of loss of the synchronous atrial kick, and 3)an increased vulnerability to thromboembolism. Patients with chronic atrial fibrillation will experience an associated thromboembolic epithod. In 1988, Harada developped right atria isolation procedure, that has electrophysiologic effects of isolating the right atrium with the origin of atrial fibrillation while preserving normal function and continuity of the sinoatrial node with the remainder of the heart.Purpose of this study is to evaluate the cardiac function and hemodynamic effects, and apply this procedure to the patients with atrial fibrillation safely. Postopeartive cardiac and hemodynamic performance from some parameter of mean atria pressure, stroke volume index, left atrial pressure, right atrial pressure and Emax does not show significant changes for preoperative performance, and remained within normal limit. From these results, this procedure was applied two patients with atrial fibrillation and atrial septal defect. Postoperative normal sinus rhythm maintained for 10 months with disappearing atrial fibrillation. We conclude that the purpose of this study was achieved from these results.