title: Atrial function after left atrial epicardial cryoablation for atrial fibrillation in patients undergoing mitral valve surgery.
abstract: OBJECTIVE
  To explore the effects on atrial and ventricular function of restoring sinus rhythm (SR) after epicardial cryoablation and closure of the left atrial appendage (LAA) in patients with mitral valve disease and atrial fibrillation (AF) undergoing surgery.
  
  
  METHODS
  Sixty-five patients with permanent AF were randomized to mitral valve surgery combined with left atrial epicardial cryoablation and LAA closure (ABL group, n = 30) or to mitral valve surgery alone (control group, n = 35). Two-dimensional and Doppler echocardiography were performed before and 6 months after surgery.
  
  
  RESULTS
  At 6 months, 73% of the patients in the ABL group and 46% of the controls were in SR. Patients in SR at 6 months had a reduction in their left ventricular diastolic diameter while the left ventricular ejection fraction was unchanged. In patients remaining in AF, the left ventricular ejection fraction was lower than at baseline. The left atrial diastolic volume was reduced after surgery, more in patients with SR than AF. In patients in SR, the peak velocity during the atrial contraction and the reservoir function were lower in the ABL group than in the control group.
  
  
  CONCLUSIONS
  In patients in SR, signs of atrial dysfunction were observed in the ABL but not the control group. Atrial dysfunction may have existed before surgery, but the difference between the groups implies that the cryoablation procedure and/or closure of the LAA might have contributed.
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: Odd
authors.initials: O
authors.lastname: Bech-Hanssen
authors.forename: Eva
authors.initials: E
authors.lastname: Berglin
authors.forename: Per
authors.initials: P
authors.lastname: Blomström
authors.forename: Anders
authors.initials: A
authors.lastname: Holmgren
authors.forename: Steen M
authors.initials: SM
authors.lastname: Jensen
authors.forename: Göran
authors.initials: G
authors.lastname: Källner
authors.forename: Leif
authors.initials: L
authors.lastname: Nilsson
authors.forename: Stefan
authors.initials: S
authors.lastname: Thelin
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.forename: Nils
authors.initials: N
authors.lastname: Edvardsson
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000601:surgery; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D003452:Cryosurgery; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010496:Pericardium / Q000601:surgery*; D016277:Ventricular Function, Left