Cryomaze ablation procedure for atrial fibrillation concomitant with valve surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SONG Long ,  LIU Liming , LI Xiaobing , YANG Benli , LIU Yuhong

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, P.R.China;

Corresponding author：

LIU Liming, Email: liulimingjia@aliyun.com

Keywords：

Heart valve surgery; atrial fibrillation; cryomaze ablation procedure

DOI：

10.7507/1007-4848.201512024

Video：

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Objective To summarize safety and effectiveness of cryomaze ablation procedure concomitant with valve surgery. Methods We retrospectively investigated the clinical data of 62 patients (24 males and 38 females) with mean age of 49.4±14.2 years who underwent cryomaze ablation procedure concomitant with valve surgery in our hospital from August 2013 through July 2015. The heart rhythm of the patients after surgery was supervised by 12-leads electrical cardiogram respectively. Results The rate of sinus rhythm restored right after surgery was 98.4%. The rate of sinus rhythm restored at the time of discharge was 93.4%. The rate of sinus rhythm restored 3 months, 6 months, 12 months, 18 months after surgery was 90.2%, 87.3%, 85.0%, 83.3% respectively. The one-year post-operation rate of sinus rhythm restored for the group of right minimal invasive thoracoscopic assisted mitral valve surgery was 90.5%. Longer duration for atrial fibrillation (>7 years) was a risk factor for the reoccurrence of atrial fibrillation 1 year after surgery (P<0.05). Conclusion Cryomaze ablation procedure concomitant with valve surgery is quite effective in treatment of rheumatic valve disease and atrial fibrillation. This approach is associated with fewer complications, comparable atrial fibrillation reoccurrence for short-term follow-up.

Citation： SONG Long, LIU Liming, LI Xiaobing, YANG Benli, LIU Yuhong. Cryomaze ablation procedure for atrial fibrillation concomitant with valve surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(5): 369-373. doi: 10.7507/1007-4848.201512024 Copy

1.	Lee R, McCarthy PM, Wang EC, et al. Midterm survival in patients treated for atrial fibrillation: a propensity-matched comparison to patients without a history of atrial fibrillation. J Thorac Cardiovasc Surg, 2012, 143(6): 1341-1351.
2.	Doll N, Borger MA, Fabricius A, et al. Esophageal perforation during left atrial radiofrequency ablation: is the risk too high? J Thorac Cardiovasc Surg, 2003, 125(4): 836-842.
3.	Cox JL. Atrial fibrillation II: rationale for surgical treatment. J Thorac Cardiovasc Surg, 2003, 126: 1693-1699.
4.	Nakajima H, Kobayashi J, Bando K, et al. The effect of cryo-maze procedure on early and intermediate term outcome in mitral valve disease: case matched study. Circulation, 2002, 106(12 Suppl 1): I46-I50.
5.	Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation: impact of the maze procedure. Circulation, 2012, 125(17): 2071-2080.
6.	Albåge A, Péterffy M, Källner G. Learning what works in surgical cryoablation of atrial fibrillation: results of different application techniques and benefits of prospective follow-up. Interact Cardiovasc Thorac Surg, 2011, 13(5): 480-484.
7.	Kim JB, Bang JH, Jung SH, et al. Left atrial ablation versus biatrial ablation in the surgical treatment of atrial fibrillation. Ann Thorac Surg, 2011, 92(4): 1397-1404.
8.	Yanagawa B, Holmes SD, Henry L, et al. Outcome of concomitant Cox-maze III procedure using an argon-based cryosurgical system: a single-center experience with 250 patients. Ann Thorac Surg, 2013, 95(5): 1633-1639.
9.	Lawrance CP, Henn MC, Miller JR, et al. A minimally invasive Cox maze IV procedure is as effective as sternotomy while decreasing major morbidity and hospital stay. J Thorac Cardiovasc Surg, 2014, 148(3): 955-961.
10.	Watkins AC, Young CA, Ghoreishi M, et al. Prospective assessment of the Cryo Maze procedure with continuous outpatient telemetry in 136 patients. Ann Thorac Surg, 2014, 97(4): 1191-1198.
11.	Sakamoto Y, Takakura H, Onoguchi K, et al. Cryosurgical left-sided maze procedure in patients with valvular heart disease: medium-term results. Ann Thorac Cardiovasc Surg, 2011, 17(2): 148-152.
12.	Funatsu T, Kobayashi J, Nakajima H, et al. Long-term results and reliability of cryothermic ablation based maze procedure for atrial fibrillation concomitant with mitral valve surgery. Eur J Cardiothorac Surg, 2009, 36(2): 267-271.
13.	Damiano RJ Jr, Schwartz FH, Bailey MS, et al. The Cox maze IV procedure: predictors of late recurrence. J Thorac Cardiovasc Surg, 2011, 141(1): 113-121.
14.	Ad N, Henry L, Hunt S, et al. Should surgical ablation for atrial fibrillation be performed in patients with a significantly enlarged left atrium? J Thorac Cardiovasc Surg, 2014, 147(1): 236-241.
15.	Moten SC, Rodriguez E, Cook RC, et al. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ, 2007, 16(Suppl3): S88-S93.
16.	Robertson JO, Cuculich PS, Saint LL, et al. Predictors and risk of pacemaker implantation after the Cox-maze IV procedure. Ann Thorac Surg, 2013, 95(6): 2015-2020.
17.	Cheema FH, Pervez MB, Mehmood M, et al. Does cryomaze injure the circumflex artery: a preliminary search for occult postprocedure stenoses. Innovations (Phila), 2013, 8(1): 56-66.
18.	Masroor S, Jahnke ME, Carlisle A, et al. Endocardial hypothermia and pulmonary vein isolation with epicardial cryoablation in a porcine beating-heart model. J Thorac Cardiovasc Surg, 2008, 135: 1327-1333.
19.	Gillinov AM, Gelijns AC, Parides MK, et al. Surgical ablation of atrial fibrillation during mitral-valve surgery. N Engl J Med, 2015, 372(15): 1399-1409.
20.	Pecha S, Schäfer T, Yildirim Y, et al. Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation. J Thorac Cardiovasc Surg, 2014, 147(3): 984-988.

1. Lee R, McCarthy PM, Wang EC, et al. Midterm survival in patients treated for atrial fibrillation: a propensity-matched comparison to patients without a history of atrial fibrillation. J Thorac Cardiovasc Surg, 2012, 143(6): 1341-1351.
2. Doll N, Borger MA, Fabricius A, et al. Esophageal perforation during left atrial radiofrequency ablation: is the risk too high? J Thorac Cardiovasc Surg, 2003, 125(4): 836-842.
3. Cox JL. Atrial fibrillation II: rationale for surgical treatment. J Thorac Cardiovasc Surg, 2003, 126: 1693-1699.
4. Nakajima H, Kobayashi J, Bando K, et al. The effect of cryo-maze procedure on early and intermediate term outcome in mitral valve disease: case matched study. Circulation, 2002, 106(12 Suppl 1): I46-I50.
5. Bum Kim J, Suk Moon J, Yun SC, et al. Long-term outcomes of mechanical valve replacement in patients with atrial fibrillation: impact of the maze procedure. Circulation, 2012, 125(17): 2071-2080.
6. Albåge A, Péterffy M, Källner G. Learning what works in surgical cryoablation of atrial fibrillation: results of different application techniques and benefits of prospective follow-up. Interact Cardiovasc Thorac Surg, 2011, 13(5): 480-484.
7. Kim JB, Bang JH, Jung SH, et al. Left atrial ablation versus biatrial ablation in the surgical treatment of atrial fibrillation. Ann Thorac Surg, 2011, 92(4): 1397-1404.
8. Yanagawa B, Holmes SD, Henry L, et al. Outcome of concomitant Cox-maze III procedure using an argon-based cryosurgical system: a single-center experience with 250 patients. Ann Thorac Surg, 2013, 95(5): 1633-1639.
9. Lawrance CP, Henn MC, Miller JR, et al. A minimally invasive Cox maze IV procedure is as effective as sternotomy while decreasing major morbidity and hospital stay. J Thorac Cardiovasc Surg, 2014, 148(3): 955-961.
10. Watkins AC, Young CA, Ghoreishi M, et al. Prospective assessment of the Cryo Maze procedure with continuous outpatient telemetry in 136 patients. Ann Thorac Surg, 2014, 97(4): 1191-1198.
11. Sakamoto Y, Takakura H, Onoguchi K, et al. Cryosurgical left-sided maze procedure in patients with valvular heart disease: medium-term results. Ann Thorac Cardiovasc Surg, 2011, 17(2): 148-152.
12. Funatsu T, Kobayashi J, Nakajima H, et al. Long-term results and reliability of cryothermic ablation based maze procedure for atrial fibrillation concomitant with mitral valve surgery. Eur J Cardiothorac Surg, 2009, 36(2): 267-271.
13. Damiano RJ Jr, Schwartz FH, Bailey MS, et al. The Cox maze IV procedure: predictors of late recurrence. J Thorac Cardiovasc Surg, 2011, 141(1): 113-121.
14. Ad N, Henry L, Hunt S, et al. Should surgical ablation for atrial fibrillation be performed in patients with a significantly enlarged left atrium? J Thorac Cardiovasc Surg, 2014, 147(1): 236-241.
15. Moten SC, Rodriguez E, Cook RC, et al. New ablation techniques for atrial fibrillation and the minimally invasive cryo-maze procedure in patients with lone atrial fibrillation. Heart Lung Circ, 2007, 16(Suppl3): S88-S93.
16. Robertson JO, Cuculich PS, Saint LL, et al. Predictors and risk of pacemaker implantation after the Cox-maze IV procedure. Ann Thorac Surg, 2013, 95(6): 2015-2020.
17. Cheema FH, Pervez MB, Mehmood M, et al. Does cryomaze injure the circumflex artery: a preliminary search for occult postprocedure stenoses. Innovations (Phila), 2013, 8(1): 56-66.
18. Masroor S, Jahnke ME, Carlisle A, et al. Endocardial hypothermia and pulmonary vein isolation with epicardial cryoablation in a porcine beating-heart model. J Thorac Cardiovasc Surg, 2008, 135: 1327-1333.
19. Gillinov AM, Gelijns AC, Parides MK, et al. Surgical ablation of atrial fibrillation during mitral-valve surgery. N Engl J Med, 2015, 372(15): 1399-1409.
20. Pecha S, Schäfer T, Yildirim Y, et al. Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation. J Thorac Cardiovasc Surg, 2014, 147(3): 984-988.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Cryomaze ablation procedure for atrial fibrillation concomitant with valve surgery

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