Serum irrigasyonlu radyofrekans ablasyon yönteminin atriyal natriüretik peptit ve hemodinami üzerine etkileri

ABSTRACTEFFECTS OF SERUM IRRIGATION RADIOFREQUENCY ABLATION TECHNIQUE ONATRIAL NATRIURETIC PEPTIDE AND HEMODYNAMICSDr.Celalettin KAYIRANSpeciality Thesis, Cardiovascular Surgery DepartmentThesis Supervisor: Doç. Dr. Haşim ÜSTÜNSOYDecember-2006 pages, 87Background: In the recent years, serum irrigation radiofrequency ablationtechnique has been used for the surgical treatment of atrial fibrillation (AF) with %80-90 efficiency. The effects of SIRFA technique on atrial natriuretic peptides andhemodynamics was investigated.Materials and methods: Between May 2005 and April 2006, 22 patients (15females, 7 males; average age 43±11) that have undergone SIRFA (Cardioblate TM.Medtronic Minneapolis- U.S.A.) treatment and 30 patients (19 females,11 malesaverage age 38,5±10) with normal sinus rhythms that haven?t undergone the SIRFAtreatment were accepted to our hospital for the study. Their effort capacities havebeen classified according to the New York Heart Association. Patients? pre-operativeand post-operative plasma atiral natriuretic peptide (ANP) levels were measured.Plasma ANP and hemodynamic parameters were compared with the controlgroup.Early post-operative transthoratic echocardiographic parameters werecompared. Mann-Whitney U, chi-square tests were performed for statistical analysis.Results: Pre-operative TTEko comparison revealed a significant difference inthe mitral valve gradient for the test group. Post-operative plasma ANP level wasfound to stay high in the test group and plasma levels inclined to rise in the fifth day.Other than right atrium in the second post operative day, urine output in the first,second, third days, using inotropic drugs and diüretics no other significant differenceswere detected in hemodynamic parameters.Conclusions: Along with its effectiveness in AF surgery, serum irrigationradiofrequency ablation does not have negative effects on plasma ANP levels andhemodynamics in early post-operative period. Metabolic effects can be also takeninto consideration in ANP level follow-ups. Studies that will include mid- and longterm plasma ANP level measurements rather than early period measurements mightbe more useful in following.Keywords: Natriüretic, Ablation, Atrial fibrillation