This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mack, C. A. Articles by Isom, O. W. Search for Related Content PubMed PubMed Citation Articles by Mack, C. A. Articles by Isom, O. W. Related Collections Ablation/ICD/surgery CV surgery: aortic and vascular disease CV surgery: coronary artery disease CV surgery: valvular disease CV surgery: other

(Circulation. 2005;112:I-1 – I-6.)
© 2005 American Heart Association, Inc.

Arrhythmia Surgery

Surgical Treatment of Atrial Fibrillation Using Argon-Based Cryoablation During Concomitant Cardiac Procedures

Charles A. Mack, MD; Federico Milla, MD; Wilson Ko, MD; Leonard N. Girardi, MD; Leonard Y. Lee, MD; Anthony J. Tortolani, MD; Justin Mascitelli; Karl H. Krieger, MD; O. Wayne Isom, MD

From the Department of Cardiothoracic Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY.

Correspondence to Charles A. Mack, MD, Department of Cardiothoracic Surgery, New York Presbyterian Hospital-Weill Cornell Medical Center, 525 East 68th St, Greenberg M-404, New York, NY 10021. E-mail cmack{at}med.cornell.edu

Background— The development of ablative energy sources has simplified the surgical treatment of atrial fibrillation (AF) during concomitant cardiac procedures. We report our results using argon-based endocardial cryoablation for the treatment of AF in patients undergoing concomitant cardiac procedures.

Methods and Results— Sixty-three patients with AF who were undergoing concomitant cardiac procedures had the same left atrial endocardial lesion set using a flexible argon-based cryoablative device. Mean age was 65.1±1.3 years. Sixty-two percent had permanent AF, whereas 38% had paroxysmal AF. Mean duration of AF was 30.5±4.8 months. Mean left atrial diameter was 5.5±0.1 cm. Mean ejection fraction was 45±1.4%. All endocardial lesions were performed for 1 minute once tissue temperature reached –40°C. Follow-up echocardiograms were obtained to determine freedom from AF. Kaplan-Meier analysis demonstrated an 88.5% freedom from AF rate at 12 months. Ablation time was 16.8±0.6 minutes. There were no in-hospital deaths and no strokes. Twelve patients (19%) required postoperative permanent pacemaker placement.

Conclusions— Cryoablation using this flexible argon-based device for the treatment of AF during concomitant cardiac procedures was safe and effective, with 88.5% of patients free from AF at 12 months.

Key Words: ablation • arrhythmia • atrial flutter • fibrillation