Surgical treatment of atrial fibrillation using argon-based cryoablation during concomitant cardiac procedures.
BACKGROUND
The development of ablative energy sources has simplified the surgical treatment of atrial fibrillation (AF) during concomitant cardiac procedures. We report our results using argon-based endocardial cryoablation for the treatment of AF in patients undergoing concomitant cardiac procedures.


RESULTS
Sixty-three patients with AF who were undergoing concomitant cardiac procedures had the same left atrial endocardial lesion set using a flexible argon-based cryoablative device. Mean age was 65.1+/-1.3 years. Sixty-two percent had permanent AF, whereas 38% had paroxysmal AF. Mean duration of AF was 30.5+/-4.8 months. Mean left atrial diameter was 5.5+/-0.1 cm. Mean ejection fraction was 45+/-1.4%. All endocardial lesions were performed for 1 minute once tissue temperature reached -40 degrees C. Follow-up echocardiograms were obtained to determine freedom from AF. Kaplan-Meier analysis demonstrated an 88.5% freedom from AF rate at 12 months. Ablation time was 16.8+/-0.6 minutes. There were no in-hospital deaths and no strokes. Twelve patients (19%) required postoperative permanent pacemaker placement.


CONCLUSIONS
Cryoablation using this flexible argon-based device for the treatment of AF during concomitant cardiac procedures was safe and effective, with 88.5% of patients free from AF at 12 months.
Mack
Charles A
CA
Department of Cardiothoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10021, USA. cmack@med.cornell.edu
Milla
Federico
F
Ko
Wilson
W
Girardi
Leonard N
LN
Lee
Leonard Y
LY
Tortolani
Anthony J
AJ
Mascitelli
Justin
J
Krieger
Karl H
KH
Isom
O Wayne
OW
D000368:Aged; D001128:Argon; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011182:Postoperative Care; D011446:Prospective Studies; D011667:Pulmonary Veins / Q000601:surgery; D016896:Treatment Outcome
D001128:Argon