title: Long-term results of cryoablation with a new cryoprobe to eliminate chronic atrial fibrillation associated with mitral valve disease.
abstract: 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.
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Sachiko
authors.initials: S
authors.lastname: Ito
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ezure
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kaneko
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nogami
mesh_terms: 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