Restoration of atrial contractility after surgical cryoablation: clinical, electrical and mechanical results.
To assess the electrical sinus rhythm (SR) recovery and the mechanical effectiveness of the atrial contraction by echocardiography is essential in patients undergoing atrial fibrillation (AF) surgery. Between September 2006 and May 2008, patients with chronic AF (n=33; permanent=23 or paroxysmal=10) underwent mitral surgery and surgical cryoablation for AF. Exclusion criteria were: AF that has persisted for 10 years and left atrium (LA) >65 mm. Echocardiography study was performed at six months after surgery. Mean age was 62 years (22 female, 11 male). Mean AF duration was three years (range 0.5-7.4). Mean atria size was 52.4+/-5.6 mm. Mitral valve surgery involved 32 prosthetic replacements and one mitral valve repair. There was no surgical mortality. Success rate for SR at three and six months was 90% and 82%, respectively. The only predictor of conversion to SR at six months was being at SR when discharge from the hospital. In patients in SR, echocardiographic study provided mechanical effectiveness of the atria in 100% of right atrium and 70% of the LA. Cryoablation for AF is an effective technique to recover electrocardiographic SR while being able to recover atrial contraction effectiveness.
Reyes
Guillermo
G
Department of Cardiovascular Surgery, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain. guillermo_reyes_copa@yahoo.es
Benedicto
Amparo
A
Bustamante
Juan
J
Sarraj
Anas
A
Nuche
José Manuel
JM
Alvarez
Pablo
P
Duarte
Juan
J
D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016275:Atrial Function; D003452:Cryosurgery / Q000009:adverse effects; D015150:Echocardiography, Doppler; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery; D009200:Myocardial Contraction; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome