title: [Biatrial vs. isolated left atrial cryoablation for the treatment of long-lasting permanent atrial fibrillation. Midterm recurrence rate].
abstract: The long-term results of cryomaze in patients with longstanding persistent atrial fibrillation during concomitant surgical procedures are still uncertain.
  
  
  METHODS
  Between 2006 and 2011, 150 consecutive patients with associated long-lasting permanent atrial fibrillation and associated heart disease underwent heart surgery were treated by biatrial Cox-Maze (63 patients) or by isolated endocardial or epicardial left atrial cryoablation (83 patients) concomitantly. The results at 3 years in these groups were compared with clinical monitoring, electrocardiography, 24-hour Holter, and echocardiography with measurement of the transmitral A wave at 1, 6 and 12 months and annually thereafter in all patients.
  
  
  RESULTS
  Patients undergoing Cox-Maze IV ablation presented rates of freedom from atrial fibrillation of 97, 94, 89, 80 and 54% at 1, 6, 12, 24 and 36 months, respectively. In the 12-month follow-up, these differences were significant (p<.05). The independent risk factors of atrial fibrillation recurrence was isolated ablation of left atrium.
  
  
  CONCLUSIONS
  Atrial fibrillation by cryothermia ablation had a high success rate before 2 years postoperatively. Recurrence of atrial fibrillation increased thereafter regardless of the technique used, although it was more intense and developed earlier in cases of monoatrial ablation. For the treatment of other long-lasting permanent atrial fibrillation cardiac surgery-associated pathology, an aggressive biatrial treatment with Cox maze ablation should be performed.
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España. Electronic address: javgua@hotmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: Gualis
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Mario
authors.initials: M
authors.lastname: Castaño
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Martínez-Comendador
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Jose Miguel
authors.initials: JM
authors.lastname: Marcos
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Estévez-Loureiro
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Gómez-Plana
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Elio
authors.initials: E
authors.lastname: Martín
authors.affiliation: Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Otero
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D013997:Time Factors
keywords: Ablación; Ablation; Arrhythmia; Arritmia; Atrial fibrillation; Cirugía; España; Fibrilación auricular; Spain; Surgery