Key result
Cryoablation with a new cryoprobe restored and maintained sinus rhythm in 61% of patients with chronic atrial fibrillation and mitral valve disease over a mean follow-up of 31 months.
Why the study?
Does concomitant cryoablation with a new cryoprobe restore and maintain sinus rhythm in patients with chronic AF undergoing mitral valve replacement?
Observational (n=66)
Does concomitant cryoablation with a new cryoprobe restore and maintain sinus rhythm in patients with chronic AF undergoing mitral valve replacement?
Concomitant cryoablation using a new spherical-tip cryoprobe during mitral valve surgery effectively restores and maintains long-term sinus rhythm in a majority of patients with chronic AF.
May support concomitant cryoablation during mitral valve surgery for chronic AF; leaves open need for randomized confirmation before practice change.
The purpose of this study was to examine the performance of a new cryoprobe in the treatment of chronic atrial fibrillation (AF) associated with mitral valve disease. The study included 66 patients undergoing mitral valve replacement. The mean AF duration was 9.0 +/- 9.0 years and mean left atrial (LA) was diameter 57 +/- 10 mm. Cryoablation (-60 degrees C) was applied to four pulmonary vein (PV) orifices over 2-3 minute. The spherical tip (2-cm in diameter) of the cryoprobe is capable of ablating the left atrium near the PV, as well as the PV ostium with a single cryoablation. After cryoablation, mitral valve surgery or a combined surgical procedure were performed in 66 patients. There were no intraoperative complications. Sinus rhythm was restored in 60 patients (91%) immediately after the operation. Recurrent AF was treated with antiarrhythmic drugs and/or direct current cardioversion in 43 patients (72%). At discharge, 48 patients (72%) were in sinus rhythm. During a mean follow-up period of 31 +/- 16 months, 40 patients (61%) were in sinus rhythm with (29) or without antiarrhythmic drugs (11). In patients in sinus rhythm at the end of the follow-up period, the duration of preoperative AF duration was significantly shorter (P < 0.05) and the preoperative LA diameter and cardiothoracic ratio were significantly smaller than in patients who were in AF (both for P < 0.005). Using this new cryoprobe, sinus rhythm was restored and maintained in 61% of patients with chronic AF and mitral valve disease with a 12-15 minute cryoablation procedure.
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Tada et al. (2005) conducted an observational in Chronic atrial fibrillation associated with mitral valve disease (n=66). Cryoablation with a new cryoprobe was evaluated on Restoration and maintenance of sinus rhythm at follow-up. Cryoablation with a new cryoprobe restored and maintained sinus rhythm in 61% of patients with chronic atrial fibrillation and mitral valve disease over a mean follow-up of 31 months.
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