Document Detail

Outcomes for surgical treatment of atrial fibrillation using cryoablation during concomitant cardiac procedures.
MedLine Citation:
PMID:  20971254     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Surgical treatment of atrial fibrillation (AF) with heat-based therapies has been associated with a high rate of arrhythmia recurrence. We studied the short-term to medium-term outcomes with a unique biatrial linear ablation procedure for AF treatment using an argon-based cryoablation device during concomitant cardiac operations. METHODS: Between March 2005 and July 2008, 57 patients (47% men) with problematic AF underwent a linear endocardial ablation procedure (Star pattern) using the flexible argon-based cryoablation probe during concomitant cardiac operations. Procedures were performed with valve or coronary operations, including mitral valve replacement (25%), mitral valve repair (16%), coronary artery bypass grafts (21%), and congenital heart surgery (8%). Atrial fibrillation was persistent or long-standing persistent in 50.9% of patients. RESULTS: Kaplan-Meier survival curves (with the standard error) demonstrated 91% (3.9%) of patients were still free of their first recurrence at 6 months, 81% (5.6%) at 12 months, and 70% (6.8%) at 24 months. Time to first recurrence was not significantly associated with age (p = 0.47), gender (p = 0.52), or type of AF (p = 0.69). There were no complications attributed to the cryoablation procedure. There was one in-hospital death and one death after discharge. Twelve patients (21%) required permanent pacemaker implantation postoperatively. There were no early or late thromboembolic events. CONCLUSIONS: This study demonstrated the medium-term efficacy of cryoablation with a unique biatrial pattern of linear lesions for the treatment of AF during a concomitant cardiac operation. Short-term to medium-term outcomes were at least equivalent to those reported for other energy modalities.
Naima M Rahman; Richard B Chard; Stuart P Thomas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1523-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Cardiology and Cardiothoracic Surgery, Westmead Hospital, Westmead, New South Wales, Australia.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / surgery*
Cardiac Surgical Procedures / methods*
Cryosurgery / methods*
Middle Aged
Treatment Outcome
Comment In:
Ann Thorac Surg. 2010 Nov;90(5):1527-8   [PMID:  20971255 ]

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