Short and Midterm Results of Epi and Endocardial Cryoablation

Background: Cryoablation is a new surgical technique for the treatment of atrial fibrillation. Because long-term results are scarce, we report on our findings with this antiarrhythmic therapy. Methods: Forty-three patients (men: 22; women: 21) with paroxysmal (20 patients) or permanent (23) atrial fibrillation underwent different cardiac procedures with simultaneous cryoablation from 2002 to 2007. Cryoablation was performed epicardially with the SurgiFrost TM Cryosurgical system in patients with closed-heart procedures and endocardially in patients with mitral valve surgery. Data were collected by reviewing charts of the patients. Follow-up data were obtained by phoning the general practitioners and/or cardiologists of the patients. Results: The mean age of the patients was 66.2 ± 9.0 years. Fifteen different operations were performed, with coronary artery bypass grafting and mitral valve replacement occurring most frequently. Four patients (9.3%) died postoperatively, 22 were discharged with sinus rhythm (56.4%), and the others demonstrated atrial fibrillation (43.6%). A cardioversion performed on 9 patients postoperatively was successful in 5. All patients were treated with phenprocoumon and amiodarone for a minimum of 6 months postoperatively. Follow-up data were collected 26 ± 15 months after surgery. The number of patients with sinus rhythm had increased to 26 (66.7%), whereas 13 (33.3%) patients still suffered from atrial fibrillation. Conclusion: Cryoablation seems to be an effective tool in the treatment of atrial fibrillation. (Ann Thorac Cardiovasc Surg 2010; 16: 340–344)