Medical and Economic Interest of the Use of Cryosurgery in the Instrumental Treatment of Atrial Fibrillation

Abstract

Introduction: In order to definitively integrate cryosurgery for the surgical treatment of atrial fibrillation (AF) into the therapeutic armamentarium, the medical and economic impact of its use on a population of patients with a high risk of recurrence of postoperative AF must be evaluated. Method: An observational study of patients who benefited from cryosurgery between July 2006 and December 2008 was performed. The cost of consumables and hospitalization was determined and compared to that of a control group of 27 patients with preoperative AF that had not benefited from cryosurgery. Results: Twenty-nine patients benefited from cryosurgery during a mitral (65.5%) or aortic intervention (37.9%) to treat a paroxystic (44.8%) or permanent AF (55.2%). More than half of them (58.6%) had a 12-month follow-up; 82.4% of these patients showed a permanent sinus rhythm and 32.6% had stopped their antiarrhythmic medication. There was no significant difference between the duration and cost of hospitalization for the 2 groups. Conclusion: Cryosurgery provides a clear clinical and economic advantage with no recurrence of AF, and it reduces antiarrhythmic medication treatment.

Crioablación biauricular frente a la ablación aislada de la aurícula izquierda en fibrilación auricular persistente. Recurrencia a medio-largo plazo

“…Aunque se han descrito anecdóticos espasmos coronarios y, por supuesto, lesión del nervio frénico 7---9 , se puede aplicar directamente sobre las arterias coronarias o tejido valvular sin complicaciones significativas. Adicionalmente, es una energía coste-eficiente 10 , su transmuralidad ha sido demostrada en humanos y en modelos animales cuando es aplicada correctamente 11,12 . La crioenergía permite realizar la lesión del itsmo de manera segura completando el aislamiento de las venas pulmonares, contribuyendo a disminuir la aparición de recurrencias de fibrilación auricular y flúter auricular a medio plazo 13 .…”