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Interact CardioVasc Thorac Surg 2009;9:609-612. doi:10.1510/icvts.2009.208173
© 2009 European Association of Cardio-Thoracic Surgery
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Institutional report - Arrhythmia

Restoration of atrial contractility after surgical cryoablation: clinical, electrical and mechanical results

Guillermo Reyesa,*, Amparo Benedictob, Juan Bustamantea, Anas Sarraja, José Manuel Nuchea, Pablo Álvareza and Juan Duartea

a Department of Cardiovascular Surgery, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain
b Department of Cardiology, Hospital Universitario La Princesa, C/Diego de León 62, 28006 Madrid, Spain

*Corresponding author. Hospital Universitario La Princesa, Servicio de Cirugía Cardiovascular, 5a planta, C/Diego de León 62, 28006 Madrid, España.

E-mail address: guillermo_reyes_copa{at}yahoo.es (G. Reyes).

To assess the electrical sinus rhythm (SR) recovery and the mechanical effectiveness of the atrial contraction by echocardiography is essential in patients undergoing atrial fibrillation (AF) surgery. Between September 2006 and May 2008, patients with chronic AF (n=33; permanent=23 or paroxysmal=10) underwent mitral surgery and surgical cryoablation for AF. Exclusion criteria were: AF that has persisted for 10 years and left atrium (LA) >65 mm. Echocardiography study was performed at six months after surgery. Mean age was 62 years (22 female, 11 male). Mean AF duration was three years (range 0.5–7.4). Mean atria size was 52.4±5.6 mm. Mitral valve surgery involved 32 prosthetic replacements and one mitral valve repair. There was no surgical mortality. Success rate for SR at three and six months was 90% and 82%, respectively. The only predictor of conversion to SR at six months was being at SR when discharge from the hospital. In patients in SR, echocardiographic study provided mechanical effectiveness of the atria in 100% of right atrium and 70% of the LA. Cryoablation for AF is an effective technique to recover electrocardiographic SR while being able to recover atrial contraction effectiveness.

Key Words: Atrial fibrillation; Cox-Maze III; Atrial mechanical function; Cryoablation; Mitral valve disease

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