Cryoablation for chronic atrial fibrillation during concomitant mitral valve surgery achieved an overall success rate of 65.5% for restoring normal sinus rhythm.
Observational (n=90)
Does cryoablation achieve normal sinus rhythm in patients with chronic atrial fibrillation undergoing concomitant mitral valve surgery?
Cryoablation during mitral valve surgery is a safe and simple procedure that achieves a 65.5% success rate in restoring sinus rhythm for patients with chronic AF.
OBJECTIVE: Although the classical Cox-Maze III is the gold standard surgical therapy with a proven efficacy in the treatment of atrial fibrillation (AF), complexity of this procedure has resulted in a search for a simpler, less invasive and more cost-effective method. In this study we evaluated the results of cryosurgical ablation in the treatment of chronic AF in patients undergoing concomitant mitral valve surgery. METHODS: Ninety patients (mean age: 50.9+/-12 years) with chronic AF who were having mitral valve surgery as the main procedure underwent cryoablation with a newly designed N(2)O-based cryotherapy device. Pulmonary vein isolation with or without left atrial appendage closure (group A) was carried out in 65 cases and cryoablative bi-atrial Cox-Maze III (group B) in 25 patients. This additional procedure took only an extra 10 min for group A and about 20 min for group B. Half of the patients received a beta-blocker following the procedure. RESULTS: The overall success rate of cryoablation was 65.5%. Normal sinus rhythm was achieved in 26.7% in the operating room, 10% in ICU and the remaining cases reverted to sinus rhythm during the follow-up period. There were no major ablation-related complications such as bleeding, thromboembolic events or A-V block. The only predictor for failure of ablative procedure was left atrial size of greater than 6 cm. CONCLUSION: Although in this study the efficacy rate of cryoablative surgery was not the same as classical Cox-Maze III, it seems that this procedure is safe, simple, cost-effective and at the same time does not increase the operative time significantly. Using cryoablation may enhance the cure rate of chronic AF during mitral valve surgery.
Ghavidel et al. (Wed,) conducted a observational in chronic atrial fibrillation (n=90). Cryoablation was evaluated on Overall success rate (restoration of normal sinus rhythm). Cryoablation for chronic atrial fibrillation during concomitant mitral valve surgery achieved an overall success rate of 65.5% for restoring normal sinus rhythm.