title: Cardiac function in relation to rhythm outcome after intraoperative epicardial left atrial cryoablation.
abstract: OBJECTIVE
  To assess the effects of intraoperative left atrial epicardial cryoablation on rhythm and atrial and ventricular function.
  
  
  METHODS
  Thirty five patients with coronary artery disease and documented atrial fibrillation underwent coronary artery bypass surgery and concomitant cryoablation. An age and gender matched control group of 35 patients with atrial fibrillation underwent bypass surgery alone. Echocardiography was performed 9 ? 32 days before and 22 ? 6 months after surgery.
  
  
  RESULTS
  The proportion of patients in sinus rhythm at follow-up was 63% and 34% (p = 0.04) in the cryoablation and control groups, respectively. In patients with sinus rhythm both before surgery and at follow-up, the left atrial area increased (p = 0.002) and the mitral annular excursion during atrial contraction decreased (p = 0.01) after cryoablation. The mitral flow velocity during atrial systole decreased after cryoablation (p = 0.002). The LV diameter increased (p = 0.03) and the left ventricular ejection fraction (LVEF) decreased (p = 0.03) in cryoablated but not in control patients. Continued deterioration was seen in patients with atrial fibrillation both pre- and postoperatively.
  
  
  CONCLUSIONS
  At long-term follow-up, a significantly higher proportion of patients was in sinus rhythm in the cryoablation than in the control group. The atrial and ventricular function had decreased at follow-up two years after surgery. This decrease was small and occurred within or close to the reference values in patients with sinus rhythm at follow-up, while patients remaining in atrial fibrillation showed a significant continued deterioration. Some subgroups were small, and the findings, although statistically significant, should be interpreted with caution.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. birgitta.ingrid.johansson@vgregion.se
authors.forename: Birgitta
authors.initials: B
authors.lastname: Johansson
authors.forename: Birgitta
authors.initials: B
authors.lastname: Houltz
authors.forename: Nils
authors.initials: N
authors.lastname: Edvardsson
authors.forename: Henrik
authors.initials: H
authors.lastname: Scherstén
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.forename: Birger
authors.initials: B
authors.lastname: Wandt
authors.forename: Eva
authors.initials: E
authors.lastname: Berglin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D001282:Atrial Flutter / Q000209:etiology / Q000503:physiopathology; D016279:Atrial Function, Left; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects / Q000401:mortality; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000503:physiopathology / Q000601:surgery*; D011237:Predictive Value of Tests; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left