EISENBERGER, Martin, Alan BULAVA, Ales MOKRACEK, Jiri HANIS, Vojtech KURFIRST and Ladislav DUŠEK. Sequential Hybrid Surgical CryoMaze and Transvenous Catheter Ablation of Atrial Fibrillation. PACE - Pacing and Clinical Electrophysiology. Hoboken: Wiley-Blackwell, 2015, vol. 38, No 12, p. 1379-1385. ISSN 0147-8389. Available from: https://dx.doi.org/10.1111/pace.12686.
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Basic information
Original name Sequential Hybrid Surgical CryoMaze and Transvenous Catheter Ablation of Atrial Fibrillation
Authors EISENBERGER, Martin (203 Czech Republic), Alan BULAVA (203 Czech Republic), Ales MOKRACEK (203 Czech Republic), Jiri HANIS (203 Czech Republic), Vojtech KURFIRST (203 Czech Republic) and Ladislav DUŠEK (203 Czech Republic, guarantor, belonging to the institution).
Edition PACE - Pacing and Clinical Electrophysiology, Hoboken, Wiley-Blackwell, 2015, 0147-8389.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.440
RIV identification code RIV/00216224:14110/15:00086897
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1111/pace.12686
UT WoS 000368084500003
Keywords in English CryoMaze; surgical ablation; catheter ablation; atrial fibrillation; hybrid approach; incomplete lines
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 4/3/2016 11:57.
Abstract
Background: The aim of the study was to evaluate whether the sequential hybrid approach combining surgical CryoMaze followed by the radiofrequency (RF) catheter ablation can improve freedom from atrial arrhythmias. Methods: Thirty-five patients with persistent atrial fibrillation underwent a CryoMaze procedure in conjunction with cardiac surgery for structural heart disease. Three months after surgery, all patients underwent a 7-day electrocardiogram Holter followed by an electrophysiological study and mapping of the left and right atria. All pulmonary veins were reisolated and all ablation lines were completed, if necessary, using RF energy. Patients were followed-up at 3 months, 6 months, and 12 months after the catheter ablation. Results: Before the mapping study and RF ablation, nine patients (26%) had ongoing atrial fibrillation or atrial tachycardia, 10 patients (28%) had paroxysmal atrial tachyarrhythmia, and 16 patients (46%) had sinus rhythm on the 7-day Holter monitoring. During the electrophysiological procedure, complete cryoablation lines around the left pulmonary veins were found in 29 patients (83%), around the right pulmonary veins in 25 patients (71%), between the superior veins in 20 patients (57%), between the inferior veins in 27 patients (77%), across the mitral isthmus in 12 patients (34%), and across the cavotricuspid isthmus in one patient (3%). Arrhythmia-free survival rate of antiarrhythmic drugs after reisolation of the veins and completion of the lines was 86% at 12 months. Conclusion: Ablation lines created using surgical CryoMaze are often incomplete. Sequential surgical CryoMaze procedures followed by catheter ablation significantly increase freedom from arrhythmia in patients with persistent atrial fibrillation.
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