Details

Autor(en) / Beteiligte

• Rahmanian, Parwis B
• Filsoufi, Farzan
• Salzberg, Sacha
• Coppolino, Anthony
• Castillo, Javier G
• Adams, David H

Titel

Surgical treatment of atrial fibrillation using cryothermy in patients undergoing mitral valve surgery

Ist Teil von

• Interactive cardiovascular and thoracic surgery, 2008-12, Vol.7 (6), p.990-995

Ort / Verlag

England: Eur Assoc Cardio Surg

Erscheinungsjahr

2008

Quelle

MEDLINE

Beschreibungen/Notizen

• Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, Mount Sinai Hospital, 1190 Fifth Avenue, Box 1028, New York, NY 10029-1028, USA Corresponding author. Tel.: +1 212 659 6820; fax: +1 212 659 6818. E-mail address : farzan.filsoufi{at}mountsinai.org (F. Filsoufi). Surgical treatment of atrial fibrillation (AF) using a variety of energy sources and a mixture of lesion sets has become an important adjunct in patients undergoing cardiac surgery. We retrospectively analyzed prospectively collected data of 141 patients with a history of AF (mean duration of AF 35±39 months; intermittent AF: n =72; 51%; permanent AF: 69 (49%)) who underwent a left-sided Cryomaze procedure in conjunction with mitral valve (MV) surgery between January 2003 and September 2006. Freedom from AF was 77% at discharge and 87% at a mean follow-up of 305±195 days with a decreasing rate of AF during the first 3–9 months from 13% to 9% and an increase beyond the first year (29% at 2 years). Predictors of failed Cryomaze in multivariate analysis were left atrial size >50 mm (OR=5.7), AF at surgery (OR=5.0) and cardiac reoperation (OR=3.4), whereas preoperative beta-blocker treatment was a predictor of success (OR=0.2). Our data suggest that a left-sided Cryomaze procedure effectively restores sinus rhythm in patients with AF undergoing MV surgery. The success rate should not be evaluated immediately postoperatively because there is a steady increase in the rate of patients with freedom from AF in the first year. It appears, however, that there is a higher rate of recurrence during later follow-up. Key Words: Atrial fibrillation; Maze procedure; Mitral valve surgery; Outcome