What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=63). Intervention: Argon-based endocardial cryoablation. Primary outcome: Freedom from atrial fibrillation.

August 30, 2005Open Access

Surgical Treatment of Atrial Fibrillation Using Argon-Based Cryoablation During Concomitant Cardiac Procedures

Key Result

Argon-based endocardial cryoablation during concomitant cardiac procedures was safe and effective, achieving an 88.5% freedom from atrial fibrillation rate at 12 months.

Study Design

Type

Observational (n=63)

Structured PICO

Does argon-based endocardial cryoablation improve freedom from atrial fibrillation in patients undergoing concomitant cardiac procedures?

Population

63 patients with atrial fibrillation (62% permanent, 38% paroxysmal) undergoing concomitant cardiac procedures, mean age 65.1 years.

Intervention

Argon-based endocardial cryoablation (left atrial endocardial lesion set using a flexible argon-based cryoablative device, 1 minute at -40 degrees C)

Outcome

Freedom from atrial fibrillation at 12 months determined by follow-up echocardiograms

Argon-based endocardial cryoablation during concomitant cardiac surgery is effective, achieving an 88.5% freedom from atrial fibrillation at 12 months, though associated with a 19% rate of permanent pacemaker placement.

Abstract

BACKGROUND: The development of ablative energy sources has simplified the surgical treatment of atrial fibrillation (AF) during concomitant cardiac procedures. We report our results using argon-based endocardial cryoablation for the treatment of AF in patients undergoing concomitant cardiac procedures. METHODS AND RESULTS: Sixty-three patients with AF who were undergoing concomitant cardiac procedures had the same left atrial endocardial lesion set using a flexible argon-based cryoablative device. Mean age was 65.1+/-1.3 years. Sixty-two percent had permanent AF, whereas 38% had paroxysmal AF. Mean duration of AF was 30.5+/-4.8 months. Mean left atrial diameter was 5.5+/-0.1 cm. Mean ejection fraction was 45+/-1.4%. All endocardial lesions were performed for 1 minute once tissue temperature reached -40 degrees C. Follow-up echocardiograms were obtained to determine freedom from AF. Kaplan-Meier analysis demonstrated an 88.5% freedom from AF rate at 12 months. Ablation time was 16.8+/-0.6 minutes. There were no in-hospital deaths and no strokes. Twelve patients (19%) required postoperative permanent pacemaker placement. CONCLUSIONS: Cryoablation using this flexible argon-based device for the treatment of AF during concomitant cardiac procedures was safe and effective, with 88.5% of patients free from AF at 12 months.