Long-term results of cryoablation with a new cryoprobe to eliminate chronic atrial fibrillation associated with mitral valve disease.
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.
Tada
Hiroshi
H
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp
Ito
Sachiko
S
Naito
Shigeto
S
Hasegawa
Yutaka
Y
Kurosaki
Kenji
K
Ezure
Masahiko
M
Kaneko
Tatsuo
T
Oshima
Shigeru
S
Taniguchi
Koichi
K
Nogami
Akihiko
A
D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D002908:Chronic Disease; D003452:Cryosurgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery; D013997:Time Factors