Results of concomitant cryoablation for atrial fibrillation during mitral valve surgery

Bogachev-Prokophiev, Alexander; Sharifulin, Ravil; Karadzha, Anastasiia; Железнев, С. И.; Afanasyev, Alexander; Овчаров, М. А.; Pivkin, Alexey; Zalesov, A.S.; Будагаев, С. А.; Ivantsov, S. M.; Chernyavsky, Alexander

doi:10.1093/icvts/ivab322

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…The weighted mean duration of AF preoperatively was 50 months (95% CI: 46.1–53.9), and weighted mean ejection fraction (EF) of 55.5% (95% CI: 53.7–57.1%). The weighted mean LA diameter was 55.7 mm (95% CI: 42.5–59.1) and four studies reported a mean LA diameter greater than 60 mm ( 19 , 21 , 29 , 50 ). These results are summarized in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Surgical ablation of atrial fibrillation during mitral valve surgery: a systematic review and meta-analysis

Eranki,

Muston,

Wilson-Smith

et al. 2024

Ann Cardiothorac Surg

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Background Atrial fibrillation (AF) is a common tachyarrhythmia, affecting approximately 33 million people worldwide, and is frequently associated with mitral valve disease. Surgical ablation during mitral valve surgery provides an opportune circumstance for arrhythmia correction. The results of recent randomized trial data are promising, demonstrating both safety and efficacy. The aim of this systematic review is to report the efficacy and morbidity of concomitant surgical ablation for AF during mitral valve surgery. Methods Five electronic databases were searched from inception to March 2023. All studies reporting the primary outcome, freedom from AF (FFAF), for patients with a history of AF undergoing concomitant mitral valve surgery were identified. Studies with patient cohorts less than 100 were excluded. Relevant data were extracted and a meta-analysis of proportions was conducted using a random-effects model. Survival data were pooled from original Kaplan-Meier curves and reconstructed, reporting aggregate FFAF and survival. Results Thirty-six studies with a total of 8,340 patients were included in the systematic review. All 36 papers reported postoperative FFAF with a pooled result of 76.9% [95% confidence interval (CI): 73.8–79.9%] at a weighted mean follow-up of 40.2 months, however this result was associated with significant heterogeneity (I 2 =89%). A total of 31 studies reported postoperative short-term mortality, with a pooled result of 1.68% (95% CI: 1.15–2.29%). Aggregate survival at 1 to 5 years was 93.7%, 92.5%, 91.3%, 89.4%, and 87%, respectively, and aggregate FFAF for 1 to 5 years was 90.2%, 83.5%, 79.5%, 76.4% and 73.2%, respectively. Conclusions Evaluation of the evidence suggests that concomitant ablation for AF during mitral valve surgery is both safe and efficacious. The results were associated with significant heterogeneity, reflective of variable institutional protocols, patient characteristics, and lesion sets. Randomized data with longer term follow-up would help validate these results.

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Section: Resultsmentioning

confidence: 99%

“….7 mm (95% CI: 42.5-59.1) and four studies reported a mean LA diameter greater than 60 mm(19,21,29,50). These results are summarized in Table2.…”

mentioning

confidence: 84%

Surgical ablation of atrial fibrillation during mitral valve surgery: a systematic review and meta-analysis

Eranki,

Muston,

Wilson-Smith

et al. 2024

Ann Cardiothorac Surg

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“…Aortic clamping time, CPB time, and postoperative complications were consistent with reports from other authors worldwide. 16,19,20 By specifically choosing patients at low or intermediate risk for minimally invasive procedures, we have established a safe population for these technically advanced surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam

Chuong,

Thuan,

Thanh

et al. 2024

Thorac Cardiovasc Surg

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Background This study presents the early and midterm outcomes of combining atrial fibrillation (AF) treatment with minimally invasive mitral valve surgery (MIMVS) at our center. Methods From January 2017 to June 2022, our center treated a total of 86 patients with both MIMVS and surgical AF ablation. The patient cohort included 62 women (72.1%) and 24 men (27.9%). The average EuroScore II was 2.64 ± 1.49%, and the patients were followed up for an average period of 46.31 ± 9.84 months. Results Postoperatively, 95.3% of patients experienced a change in sinus rhythm, and 86.2% were discharged in sinus rhythm. The hospital's mortality rate was 2.3%, with a late mortality rate of 3.5%. Survival analysis revealed an atrial fibrillation–free 5-year follow-up rate of 59.1 ± 9.1%. The 5-year survival rate was 92.7 ± 3.3%. Conclusion Our 5-year experience demonstrates that the combination of MIMVS and surgical AF ablation can be routinely performed with favorable peri- and postoperative outcomes. This reflects our hospital's culture and guidance on patient selection, particularly when adopting minimally invasive approaches for multiple procedures.

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Results of concomitant cryoablation for atrial fibrillation during mitral valve surgery

Cited by 2 publications

References 28 publications

Surgical ablation of atrial fibrillation during mitral valve surgery: a systematic review and meta-analysis

Surgical ablation of atrial fibrillation during mitral valve surgery: a systematic review and meta-analysis

Concomitant Surgical Ablation for Treatment of Atrial Fibrillation in Patients Undergoing Minimally Invasive Mitral Valve Surgery: A Single-Center Experience in Vietnam

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