The Factors Affecting Rhythm Control for Cryoablation of Atrial Fibrillation in Mitral Valve Surgery

Abstract

ObjectiveTo evaluate the factors impacting on the conversion to sinus rhythm and on the postoperative rhythm findings in the six-month follow-up period of a mitral valve surgery combined with cryoablation Cox-Maze III procedure, in patients with atrial fibrillation.MethodsIn this study, we evaluated 80 patients who underwent structural valve disease surgery in combination with cryoablation. Indications for the surgical procedures were determined in the patients according to the presence of rheumatic or non-rheumatic structural disorders in the mitral valve as evaluated by echocardiography. Cox-Maze III procedure and left atrial appendix closure were applied.ResultsThe results of receiver operating characteristics analysis indicated that the rate of conversion to the sinus rhythm was significantly higher in patients with left atrial diameters ≥ 45.5 mm and with ejection fraction (EF) ≥ 48.5%. However, the statistical differences disappeared in the sixth month. Thromboembolic (TE) events were seen only in three patients in the early period and no more TE events occurred in the six-month follow-up period.ConclusionThe EF and the preoperative left atrial diameter were determined to be the factors impacting on the conversion to sinus rhythm in patients who underwent mitral valve surgery in combination with cryoablation. Mitral valve surgery in combination with ablation for atrial fibrillation does not affect mortality and morbidity in the experienced health centers; however, it remains controversial whether it will provide additional health benefits to the patients compared to those who underwent only mitral valve surgery.

Predictability of Atrial Fibrillation in Patients having Coronary Artery Bypass Graft Surgery, Based on Selvester Score

“…In order to lower the morbidity and mortality rates from such a frequent complication, preoperative risk factors should essentially be identified along with the development of clinical predictive models and prophylactic strategies 7,8 . In patients under 70 years of age, who undergo CABG, the incidence of AF in the first post-operative year is higher, indicating its association with higher renal dysfunction and infection [9][10][11][12][13] .…”