Vol. 22 No. 3 (2018)
CASE REPORTS

Surgical treatment of incisional tachycardia and atrial fibrillation in patients with mitral valve prosthesis: should we be scared?

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  • O. Sapelnikov,
  • O. Nikolaeva,
  • D. Ardus,
  • D. Cherkashin,
  • I. Grishin,
  • N. Shlevkov,
  • A. Zhambeev,
  • H. Salami,
  • R. Akchurin
O. Sapelnikov
National Medical Research Center of Cardiology, Moscow, Russian Federation
O. Nikolaeva
National Medical Research Center of Cardiology, Moscow, Russian Federation
Bio
D. Ardus
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
D. Cherkashin
National Medical Research Center of Cardiology, Moscow, Russian Federation
I. Grishin
National Medical Research Center of Cardiology, Moscow, Russian Federation
N. Shlevkov
National Medical Research Center of Cardiology, Moscow, Russian Federation
A. Zhambeev
National Medical Research Center of Cardiology, Moscow, Russian Federation
H. Salami
National Medical Research Center of Cardiology, Moscow, Russian Federation
R. Akchurin
National Medical Research Center of Cardiology, Moscow, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2018-3-75-80

Published 2018-11-20

Keywords

  • case report,
  • atrial fibrillation,
  • incisional tachycardia,
  • atrial flutter,
  • mitral valve replacement

How to Cite

Sapelnikov, O., Nikolaeva, O., Ardus, D., Cherkashin, D., Grishin, I., Shlevkov, N., Zhambeev, A., Salami, H., & Akchurin, R. (2018). Surgical treatment of incisional tachycardia and atrial fibrillation in patients with mitral valve prosthesis: should we be scared?. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 22(3), 75–80. https://doi.org/10.21688/1681-3472-2018-3-75-80

Copyright (c) 2018 Sapelnikov O. V., Nikolaeva O. A., Ardus D. F., Cherkashin D. I., Grishin I. R., Shlevkov N. B., Zhambeev A. A., Salami H. F., Akchurin R. S.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Mitral valve disease, including dysfunction of the mitral valve, is often accompanied by atrial fibrillation. Among the patients with prosthetic mitral valves, atrial fibrillation occurs in 30–50% cases. Development of atrial arrhythmias and incisional tachycardia in the early and late postoperative periods can significantly influence patients’ rehabilitation and prognosis. Our clinical case describes a patient with a mechanical mitral valve and incisional tachycardia, which led to progression of heart failure and reduced left ventricular systolic function. The patient underwent catheter ablation with non-invasive myocardium mapping. The case reveals the potentials of treatment of incisional tachycardia and atrial fibrillation, which do not respond to drug therapy. Modern methods of visualization enable the cardiac surgeons to reduce possible intraoperative risks and development of complications in this group of patients.

Received 14 August 2018. Revised 2 October 2018. Accepted 3 October 2018.

Informed consent: The patient gave informed consent to use his medical data for scientific purposes. Identifying details are omitted.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflict of interest.

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References

  1. Gillinov A.M., Saltman A.E. Ablation of atrial fibrillation with concomitant cardiac surgery. Semin Thorac Cardiovasc Surg. 2007;19(1):25-32. PMID: 17403454 https://doi.org/10.1053/j.semtcvs.2007.01.002
  2. Ивлева О.В., Авдеева М.В. Влияние протезирования митрального клапана на функциональную перестройку сердца у больных с синусовым ритмом и фибрилляцией предсердий. Креативная кардиология. 2018;12(1):40-49. [Ivleva O.V., Avdeeva M.V. Influence of mitral valve replacement on functional heart restoration in patients with sinus rhythm and atrial fibrillation. Creative Cardiology = Kreativnaya Kardiologiya. 2018;12(1):40-9 (in Russ.)]
  3. Тукушева Э.Н., Абдраманов К.А., Урманбетов К.С. Влияние мерцательной аритмии на оценку качества жизни после хирургической коррекции митральной недостаточности ревматического генеза. Новая наука: опыт, традиции, инновации. 2016;(10-2):36-43 [Tukusheva E.N., Abdramanov K.A., Urmanbetov K.S. Impact of atrial fibrillation on the evaluation of quality of life following surgical repair of rheumatic mitral valve insufficiency. Novaya nauka: opyt, traditsii, innovatsii. 2016;(10-2):36-43 (in Russ.)]
  4. Marrouche N.F., Brachmann J., Andresen D., Siebels J., Boersma L., Jordaens L., Merkely B., Pokushalov E., Sanders P., Proff J., Schunkert H., Christ H., Vogt J., Bänsch D.; CASTLE-AF Investigators. Catheter ablation for atrial fibrillation with heart failure. N Engl J Med. 2018;378(5):417-427. PMID: 29385358. https://doi.org/10.1056/NEJMoa1707855
  5. Абдульянов И.В., Вагизов И.И., Мухарямов М.Н. Эффективность лечения фибрилляции предсердий методом радиочастотной аблации у пациентов с хирургическим вмешательством на митральном клапане. Медицинский альманах. 2015;(3):54-56 [Abdulianov I.V., Vagizov I.I., Mukharyamov M.N. Efficiency of atrium fibrillation treatment using the method of radiofrequency ablation in the case of patients with surgical treatment of mitral valve. Medicinskij al'manah. 2015;(3):54-56.(In Russ.)]
  6. Wang X., Liu X., Shi H., Gu J., Sun Y., Zhou, L., Hu W. Heart rhythm disorders and pacemakers: Pulmonary vein isolation combined with substrate modification for persistent atrial fibrillation treatment in patients with valvular heart diseases. Heart. 2009;95(21):1773-83. PMID: 19482843. https://doi.org/10.1136/hrt.2007.124594
  7. Lang C.C., Santinelli V., Augello G., Ferro A., Gugliotta F., Gulletta S., Vicedomini G., Mesas C., Paglino G., Sala S., Sora N., Mazzone P., Manguso F., Pappone C. Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria: safety, feasibility, and efficacy. J Am Coll Cardiol. 2005;45(6):868-72. PMID: 15766822. https://doi.org/10.1016/j.jacc.2004.11.057
  8. Ad N., Holmes S.D., Massimiano P.S., Rongione A.J., Fornaresio L.M. Long-term outcome following concomitant mitral valve surgery and Cox maze procedure for atrial fibrillation. J Thorac Cardiovasc Surg. 2018;155(3):983-994. PMID: 29246544. PMCID: PMC5933444. https://doi.org/10.1016/j.jtcvs.2017.09.147
  9. Ad N., Holmes S.D., Massimiano P.S., Pritchard G., Stone L.E., Henry L. The effect of the Cox-maze procedure for atrial fibrillation concomitant to mitral and tricuspid valve surgery. J Thorac Cardiovasc Surg. 2013;146(6):1426-34. https://doi.org/10.1016/j.jtcvs.2013.08.013
  10. Суханов С.Г., Шатахян М.П., Арусланова О.Р., Зерр К.Д. Результаты левопредсердных операций «Лабиринт» в лечении фибрилляции предсердий в сочетании с хирургией митрального клапана. Анналы аритмологии. 2011;8(2):17-23. [Sukhanov S.G., Shatakhyan M.P., Aruslanova O.R., Zehr K.J. Results of left atrial procedures «Maze» in the treatment of atrial fibrillation combined with bicuspid valve surgery. Annaly aritmologii. 2011;8(2):17-23. (In Russ.)]
  11. Сапельников О.В., Черкашин Д.И., Шлевков Н.Б., Николаева О.А., Жамбеев А.А., Салами Х.Ф., Партигулова А.С., Булдакова Н.А., Гришин И.Р., Ардус Д.Ф., Стукалова О.В., Ускач Т.М., Жиров И.В., Терещенко С.Н., Терновой С.К., Акчурин Р.С. Сравнительная эффективность изоляции легочных вен и аблации фокусов роторной активности у пациентов с персистирующей формой фибрилляции предсердий: средне-отдаленные результаты. Кардиологический вестник. 2017;12(4):38-43. [Sapelnikov O.V., Cherkashin D.I., Shlevkov N.B., Nikolaeva O.A., Zhambeev A.A., Salami Kh.F., Partigulova A.S., Buldakova N.A., Grishin I.R., Ardus D.F., Stukalova O.V., Uskach T.M., Zhirov I.V., Tereshchenko S.N., Ternovoi S.N., Akchurin R.S. Comparative efficacy of pulmonary vein isolation vs rotor ablation in patients with persistent atrial fibrillation: mid-term results. Kardiologicheskii vestnik. 2017;12(4):38-43. (In Russ.)]
  12. Сапельников О.В., Черкашин Д.И., Гришин И.Р., Шлевков Н.Б., Жамбеев А.А., Салами Х.Ф., Ускач Т.М., Николаева О.А., Стукалова О.В., Чапурных А.В., Ширяев А.А., Акчурин Р.С., Ардус Д.Ф. Аблация роторных очагов по данным неинвазивного картирования у пациентов с персистирующей и длительно-персистирующей фибрилляцией предсердий: средне-отдаленные результаты. Медицинский альманах. 2017;(3):89-92. [Sapelnikov O.V., Cherkashin D.I., Grishin I.R., Shlevkov N.B., Zhambeyev A.A., Salami Kh.F., Uskach T.M., Nikolayeva O.A., Stukalova O.V., Chapurnykh A.V., Shiryaev A.A., Akchurin R.S., Ardus D.F. Ablation of rotor foci in accordance with the data of non-invasive mapping of patients having persistent and long-term persistent atrial fibrillation: medium-to-long-term results. Medicinskij al'manah. 2017;(3):89-92. (In Russ.) http://dx.doi.org/10.21145/2499-9954-2017-3-89-92]
  13. Bogachev-Prokophiev A.V., Afanasyev A.V., Pivkin A.N., Ovcharov M.A., Zheleznev S.I., Sharifulin R.M., Karaskov A.M. A left atrial versus a biatrial lesion set for persistent atrial fibrillation ablation during open heart surgery. Eur J Cardiothorac Surg. 2018;54(4):738-744. PMID: 29608679. https://doi.org/10.1093/ejcts/ezy126
  14. Покушалов Е.А., Туров А.Н., Шугаев П.Л., Артеменко С.Н., Баранова В.В., Железнев С.И., Богачев-Прокофьев А.В. Катетерная аблация инцизионного трепетания предсердий после протезирования митрального клапана и процедуры Cox/Maze III. Вестник аритмологии. 2005;(40):64-66. [Pokushalov E.A., Turov A.N., Shugaev P.L., Artemenko S.N., Baranova V.V., Zheleznev S.I., Bogachev-Prokophiev A.V. Catheter ablation of incisional atrial fibrillation following mitral valve replacement and Cox/Maze III procedure. Journal of arrhythmology. 2005;(40):64-66. (In Russ.)]