Why the study?
Despite the frequent use of cryoenergy in surgical ablation of AF, the clinical effect of endocardial and epicardial approaches remained unknown.
Does endocardial cryoenergy ablation improve the completeness of lesions and sinus rhythm compared to epicardial ablation in patients undergoing concomitant surgical ablation of atrial fibrillation?
Population
55 patients undergoing concomitant AF surgical ablation using cryoenergy
Comparison
Epicardial ablation on arrested heart vs epicardial on beating heart vs endocardial ablation
Key result
Endocardial application of cryoenergy during surgical ablation of atrial fibrillation achieved 95% completeness of pulmonary vein isolation, compared to 31% and 25% with epicardial approaches on arrested and beating hearts, respectively.
Authors
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Endocardial cryoablation was associated with higher lesion completeness; leaves open whether this improves sinus rhythm in randomized trials.
Observational (n=55)
No
Does endocardial cryoenergy ablation improve the completeness of lesions and sinus rhythm compared to epicardial ablation in patients undergoing concomitant surgical ablation of atrial fibrillation?
Absolute Event Rate: 95% vs 31%
Endocardial application of cryoenergy during surgical ablation of atrial fibrillation results in significantly higher rates of complete pulmonary vein isolation and box lesions compared to epicardial approaches.
Kurfirst et al. (2020) conducted an observational in Atrial fibrillation (n=55). Endocardial cryoenergy ablation vs. Epicardial cryoenergy ablation (arrested or beating heart) was evaluated on Completeness of pulmonary vein isolation. Endocardial application of cryoenergy during surgical ablation of atrial fibrillation achieved 95% completeness of pulmonary vein isolation, compared to 31% and 25% with epicardial approaches on arrested and beating hearts, respectively.
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