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 6 publications

(4 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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“…In addition to the NSR of antiarrhythmic medications (79%, 84%, and 82%, respectively), they discovered that a high return to normal sinus rhythm (NSR) was recorded at 6, 12, and 24 months (92%, 91%, and 86%, respectively) ( 39 ). Bogachev-Prokophiev et al also showed that concomitant AF cryoablation with mitral valve surgery provided an acceptable level of abstinence from recurrent atrial arrhythmias throughout long-term monitoring ( 40 ). These studies suggest that during mitral valve surgery, concurrent cryoablation is a safe and reliable procedure and can be used as a safe and effective treatment for patients with AF combined with mitral valve disease.…”

Section: Surgical Ablation Technologymentioning

confidence: 99%

Surgical treatment of atrial fibrillation in mitral valve surgery: a narrative review

Zou,

Yang,

Ding

et al. 2024

J Thorac Dis

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Background and Objective Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice, which leads to cardiac decompensation, cardiovascular and cerebrovascular infarction, and other thromboembolic diseases. AF is one of the most common comorbidities of valvular heart disease, especially in mitral valve disease. At the time of their mitral valve surgery, 20–42% of patients have AF. It is beneficial to maintain postoperative sinus rhythm and minimize complications when AF surgery is performed concurrently with mitral valve surgery. This review describes the surgical management of AF in mitral valve surgery, including AF surgical route, surgical ablation technology and surgical approaches. The aim of this review is to enable more patients with AF to receive more appropriate and individualised treatment. Methods A narrative review was conducted on the literature on PubMed, Embase including all relevant studies published until November 2023. Key Content and Findings This review focuses on the surgical management of AF during mitral valve surgery, including AF surgical route, surgical ablation technology and surgical approaches. Conclusions Mitral valve surgery combined with AF surgery facilitates the maintenance of postoperative sinus rhythm in patients, reduces the risk of postoperative stroke, and improves survival. Advances in ablation technology have reduced the difficulty of the procedure, making it possible for more patients to undergo surgical ablation. In the future, it will be possible to tailor specific lesion sets and ablation modalities for individual patients. This would make surgical treatment of AF more effective and applicable to a larger population of patients with AF and mitral valve disease.

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Results of concomitant cryoablation for atrial fibrillation during mitral valve surgery

Cited by 6 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

Surgical treatment of atrial fibrillation in mitral valve surgery: a narrative review

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