Surgical Treatment of Atrial Fibrillation Using Cryoablation in Patients With Rheumatic Mitral Valve Disease and Atrial Fibrillation, for the First Time in Kazakhstan

Background. This study presents the results of a clinical trial evaluating the effectiveness of surgical treatments for atrial fibrillation in patients with rheumatic mitral valve disease. Special attention is given to the comparison of cryoablation and radiofrequency ablation, two methods used in conjunction with mitral valve surgeries. The results indicate that cryoablation, a method first used in Kazakhstan, has long-term advantages for restoring sinus rhythm and cardiac remodeling, thereby improving patients' quality of life. Materials and Methods. The study was conducted at the period from January 2020 to March 2024 through a retrospective analysis of data from patients with atrial fibrillation and rheumatic mitral valve disease who underwent surgical treatment using one of two methods: Cryoablation with left atrial appendage clipping (Group I) – 50 patients; Radiofrequency ablation with left atrial appendage suturing (Group II) – 50 patients. Results. According to the conducted research, both cryoablation and radiofrequency ablation are highly effective in restoring sinus rhythm in patients with atrial fibrillation and rheumatic mitral valve disease. Cryoablation, a procedure that was used for the first time in Kazakhstan, demonstrated significant advantages in the long-term maintenance of sinus rhythm and improvement in heart remodeling parameters, such as left atrial volume. This has enhanced the quality of life for patients. Conclusions. There is a need for the widespread implementation of innovative treatments for atrial fibrillation, such as cryoablation, as surgical procedures are more effective and patients with severe cardiovascular diseases have better outcomes.