title: Left atrial appendage outflow velocity is superior to conventional criteria for predicting of maintenance of sinus rhythm after simple cryoablation of pulmonary vein orifices.
abstract: BACKGROUND
  We sought to identify factors favoring long-term restoration of sinus rhythm (SR) in patients with atrial fibrillation (AF) who underwent a simple cryoablation of pulmonary vein orifices (PV-cryo) as part of their cardiac surgery.
  
  
  RESULTS
  Of 101 patients with AF undergoing PV-cryo, the 71 in SR at discharge were grouped according to whether they maintained or lost SR (group SR, n = 61, and group AF, n = 10) after an average of 2.3 years. Atrial fibrillation present at discharge (n = 30) persisted during follow up. Comparisons were made to identify preoperative predictive factors, including transthoracic and transesophageal echocardiographic parameters. Of patients discharged from the hospital with SR, 92% (46 of 50) of those with AF duration of 3 years or less were in group SR, as were 92% (23 of 25) of those with left atrial dimension of 50 mm or less, and 93% (37 of 40) of those with average peak left atrial appendage outflow velocities (LAA-V) of at least 30 cm/s. Of 25 patients in group SR who had no paroxysmal AF and did not require antiarrhythmic drugs, all had LAA-V over 20 cm/s. Patients in group AF all had LAA-V under 40 cm/s.
  
  
  CONCLUSIONS
  Left atrial appendage outflow velocities was the best predictor of whether SR was maintained long-term after PV-cryo.
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi 371-0004, Japan. isobe.n@cvc.pref.gunma.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Isobe
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ezure
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kaneko
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Adachi
authors.forename: Takuji
authors.initials: T
authors.lastname: Toyama
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hoshizaki
mesh_terms: D000368:Aged; D001146:Arrhythmia, Sinus / Q000175:diagnosis; D020517:Atrial Appendage / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery; D016279:Atrial Function, Left; D001783:Blood Flow Velocity; D003452:Cryosurgery; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery*