Alternative energy sources for surgical treatment of atrial fibrillation in patients undergoing mitral valve surgery: microwave ablation vs cryoablation.
The study aim was to compare maze outcomes using microwave ablation or cryoablation in patients with mitral disease and atrial fibrillation (AF). Between 1999 and 2005, 340 patients underwent mitral valve surgery and concomitant maze procedure involving either microwave ablation (n=96, MW group) or cryoablation (n=244, Cryo group). Mean age at operation was 50.0±12.5 yr. Follow-up period was 46.1±28.2 months. The Cryo group showed a longer aortic clamping time than the MW group (P=0.005). There were no differences in operative mortality and morbidity rates. The unadjusted 5-yr AF free rate was 61.3±1.2% in the MW group and 79.9±3.2% in the Cryo group (P=0.089). After adjustment, the MW group only showed a tendency toward more frequent AF recurrence than the Cryo group (Hazard ration 1.66, 95% confidence interval 0.89 to 3.07). Multivariate analysis revealed that older patient age (P<0.001) and greater left atrial size (P<0.001) were independent risk factors for AF recurrence. Although the use of microwave ablation results in shorter aortic clamping time, it has a tendency toward more frequent late AF recurrence than with cryoablation.
Kim
Joon Bum
JB
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Cho
Won-Chul
WC
Jung
Sung Ho
SH
Chung
Cheol Hyun
CH
Choo
Suk Jung
SJ
Lee
Jae Won
JW
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D003452:Cryosurgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*