Left atrial appendage outflow velocity is superior to conventional criteria for predicting of maintenance of sinus rhythm after simple cryoablation of pulmonary vein orifices.
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.
Isobe
Naoki
N
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi 371-0004, Japan. isobe.n@cvc.pref.gunma.jp
Taniguchi
Koichi
K
Oshima
Shigeru
S
Kamiyama
Hiroshi
H
Ezure
Masahiko
M
Kaneko
Tatsuo
T
Tada
Hiroshi
H
Adachi
Hitoshi
H
Toyama
Takuji
T
Naito
Shigeto
S
Hoshizaki
Hiroshi
H
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*