Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery

Gaïta, Fiorenzo; Gallotti, Roberto; Calò, Leonardo; Manasse, Eric; Riccardi, Riccardo; Garberoglio, Lucia; Nicolini, Francesco; Scaglione, Mariano; Donna, Paolo Di; Caponi, Domenico; Franciosi, Giorgio

doi:10.1016/s0735-1097(00)00657-4

Cited by 85 publications

(49 citation statements)

References 24 publications

(44 reference statements)

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“…Sinus rhythm was restored in 20 of 29 patients [69%) with chronic AF undergoing this procedure. 89 Ablation of pulmonary vein foci that cause AF is a developing area in the treatment of AF. However, recurrent AF develops in 40% to 60% of patients despite initial efficacy with this procedure.…”

Section: 84mentioning

confidence: 99%

Atrial Fibrillation: The New Epidemic of the Ageing World

Aronow¹,

Banach²

2009

J.A.F.I.B

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The prevalence of atrial fibrillation (AF) increases with age. As the population ages, the burden of AF increases.AF is associated with an increased incidence of mortality, stroke, and coronary events compared to sinus rhythm. AF with a rapid ventricular rate may cause a tachycardia-related cardiomyopathy. Immediate direct-current (DC) cardioversion should be performed in patients with AF and acute myocardial infarction, chest pain due to myocardial ischemia, hypotension, severe heart failure, or syncope. Intravenous beta blockers, diltiazem, or verapamil may be administered to reduce immediately a very rapid ventricular rate in AF. An oral beta blocker, verapamil, or diltiazem should be used in persons with AF if a fast ventricular rate occurs at rest or during exercise despite digoxin. Amiodarone may be used in selected patients with symptomatic life-threatening AF refractory to other drugs. Digoxin should not be used to treat patients with paroxysmal AF. Nondrug therapies should be performed in patients with symptomatic AF in whom a rapid ventricular rate cannot be slowed by drugs. Paroxysmal AF associated with the tachycardia-bradycardia syndrome should be treated with a permanent pacemaker in combination with drugs. A permanent pacemaker should be implanted in patients with AF and symptoms such as dizziness or syncope associated with ventricular pauses greater than 3 seconds which are not drug-induced. Elective DC cardioversion has a higher success rate and a lower incidence of cardiac adverse effects than does medical cardioversion in converting AF to sinus rhythm. Unless transesophageal echocardiography has shown no thrombus in the left atrial appendage before cardioversion, oral warfarin should be given for 3 weeks before elective DC or drug cardioversion of AF and continued for at least 4 weeks after maintenance of sinus rhythm. Many cardiologists prefer, especially in elderly patients , ventricular rate control plus warfarin rather than maintaining sinus rhythm with antiarrhythmic drugs. Patients with chronic or paroxysmal AF at high risk for stroke should be treated with long-term warfarin to achieve an International Normalized Ratio of 2.0 to 3.0. Patients with AF at low risk for stroke or with contraindications to warfarin should be treated with aspirin 325 mg daily

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Section: 84mentioning

confidence: 99%

Atrial Fibrillation: The New Epidemic of the Ageing World

Aronow¹,

Banach²

2009

J.A.F.I.B

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“…1 Results have been described by several investigators. [2][3][4][5] Gaita et al performed limited posterior left atrial cryoablation in patients with chronic AF during valvular heart surgery, successfully restoring SR in only 69% of 29 survivors after 9 months of follow up. 2 Imai et al described outcomes following 32 simple left atrial procedures for chronic AF associated with mitral valve disease, with 74% of patients maintaining SR after an average follow-up period of 37 months.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

“…[2][3][4][5] Gaita et al performed limited posterior left atrial cryoablation in patients with chronic AF during valvular heart surgery, successfully restoring SR in only 69% of 29 survivors after 9 months of follow up. 2 Imai et al described outcomes following 32 simple left atrial procedures for chronic AF associated with mitral valve disease, with 74% of patients maintaining SR after an average follow-up period of 37 months. 3 Kalil et al reported that 92.3% of 15 patients with mitral valve disease had returned to SR after simple surgical isolation of the pulmonary veins and remained in SR at 6 months of follow up.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

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Left Atrial Appendage Outflow Velocity is Superior to Conventional Criteria for Predicting of Maintenance of Sinus Rhythm After Simple Cryoablation of Pulmonary Vein Orifices

Isobe

Taniguchi

Kono

et al. 2005

Circ J

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ince Haissaguerre et al reported that most atrial premature beats that initiate atrial fibrillation (AF) originate in the pulmonary veins (PV), various surgical techniques have been devised to isolated PV by incision and/or cryoablation. [1][2][3][4][5] In this context, we have used simple surgical cryoablation confined to the 4 PV orifices (PV-cryo) to eliminate chronic AF in appropriate patients undergoing cardiac surgery since 1999. We previously reported initial results in which 70% of patients showed sinus rhythm (SR) at discharge from the hospital. 6 Furthermore, we found that the duration of AF (AF-D), left atrial dimension (LAD), and the mean of peak left atrial appendage outflow velocities (LAA-V) before operation were important factors in assessing the likelihood of successful conversion from AF to SR. 6 In this study, the patients were followed up for a relatively long period of time to determine whether maintenance of SR was related to these variables as well as which of the variables was the best long-term predictor of SR. Methods PatientsWe carried out PV-cryo as part of a cardiac operation at our hospital in 101 patients with a history of chronic AF.

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“…40 Intraoperative creation of linear cryolesions has also been shown to be effective and safe in the cure of AF in patients with associated valvular disease. 41 Cryoablation may therefore be a possible alternative to the maze procedure, reducing myocardial ischemic time and the risk of bleeding. In addition, cryoablation could also replace RF energy in transmural catheter ablation procedures.…”

Section: Different Energy Sources For Catheter Ablationmentioning

confidence: 99%

Catheter ablation of atrial fibrillation

Camm

2002

Clinical Cardiology

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SummaryFollowing the advent of the surgical maze procedure, several catheter techniques have been developed to provide permanent prophylaxis against atrial fibrillation. These noninvasive techniques work by compartmentalizing the atria, by ablating the arrhythmogenic foci, or by isolating the atria from these foci. Although still at an early stage of development, preliminary results using focal ablation and circumferential ablation show extreme promise.

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Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery

Cited by 85 publications

References 24 publications

Atrial Fibrillation: The New Epidemic of the Ageing World

Atrial Fibrillation: The New Epidemic of the Ageing World

Left Atrial Appendage Outflow Velocity is Superior to Conventional Criteria for Predicting of Maintenance of Sinus Rhythm After Simple Cryoablation of Pulmonary Vein Orifices

Catheter ablation of atrial fibrillation

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