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Objective: This prospective randomized all-comers study was constructed to compare effectiveness of endocardial cryoablation and radiofrequency ablation in surgical treatment of atrial fibrillation (AF) in “real world” not selected consecutive mitral valve patients.
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Piotr Suwalski1, Grzegorz Suwalski1, Janusz Kochanowski2, Piotr Scislo2, Mariusz Sledz1, Anna Oginska1, Julita Switaj1, Kazimierz B. Suwalski1.
1Cardiac Surgery Derpartment, Medical University of Warsaw, Warsaw, Poland, 2Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Methods: Between January 2002 and June 2006 91 patients with AF were submitted to different combination of mitral valve surgery and randomized to concominant left atrial modified Maze procedure using either irrigated radiofrequency energy (group I, n=55) or liquid nitrogen cryothermy (group II, n=36). Mean values of age (61,5; +/-9,2 years), left atrial diameter (54; +/-10 mm), AF duration (3,8; +/-4,2 years), ejection fraction (50,5; +/-11,6 %), NYHA class (2,3; +/-0,6); Euroscore (6,9; +/-6,8 %) did not signifficantly differ between groups. Prospective follow-up was collected during hospitalization and 3, 6, 12, 24 months after discharge including 24-hours Holter ECG and echocardiography.
Results: There was no in-hospital mortality. 3 patients died in follow-up. Sinus rhythm rates were observed in group I and II respectively at ICU discharge (65,3% vs. 74,2%), at hospital discharge (75% vs. 72,2%), after 3 months (58,3% vs. 64,7%), after 6 months (74,4% vs. 64,5%), after 12 months (63,3% vs. 69,2%) and after 24 months (58,3% vs. 64,7%). None of differences were statisticaly signifficant (p<0,05).
Conclusions: Endocardial cryoablation and radiofrequency ablation for treatment of AF give similar results in long-term follow-up in real world non selected population of mitral valve patients.
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