Effect of cryothermic and radiofrequency Cox-Maze IV ablation on atrial size and function assessed by 2D and 3D echocardiography, a randomized trial. To freeze or to burn

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Boano, GabriellaLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland (author)

Effect of cryothermic and radiofrequency Cox-Maze IV ablation on atrial size and function assessed by 2D and 3D echocardiography, a randomized trial. To freeze or to burn

Article/chapterEnglish2023

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WILEY,2023
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LIBRIS-ID:oai:DiVA.org:liu-196761
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-196761URI
https://doi.org/10.1111/cpf.12841DOI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agencies|ALF Grant Region Ostergotland
BackgroundAtrial linear scars in Cox-Maze IV procedures are achieved using Cryothermy (Cryo) or radiofrequency (RF) techniques. The subsequent postoperative left atrial (LA) reverse remodelling is unclear. We used 2- and 3-dimensional echocardiography (2-3DE) to compare the impact of Cryo and RF procedures on LA size and function 1 year after Cox-maze IV ablation concomitant with Mitral valve (MV) surgery. MethodsSeventy-two patients with MV disease and AF were randomized to Cryo (n = 35) or RF (n = 37) ablation. Another 33 patients were enroled without ablation (NoMaze). All patients underwent an echocardiogram the day before and 1 year after surgery. The LA function was assessed on 2D strain by speckle tracking and 3DE. ResultsForty-two ablated patients recovered sinus rhythm (SR) 1 year after surgery. They had comparable left and right systolic ventricular function, LA volume index (LAVI), and 2D reservoir strain before surgery. At follow-up, the 3DE extracted reservoir and booster function were higher after RF (37 & PLUSMN; 10% vs. 26 & PLUSMN; 6%; p < 0.001) than Cryo ablation (18 & PLUSMN; 9 vs. 7 & PLUSMN; 4%; p < 0.001), while passive conduit function was comparable between groups (24 & PLUSMN; 11 vs. 20 & PLUSMN; 8%; p = 0.17). The extent of LAVI reduction depended on the duration of AF preoperatively. ConclusionsSR restoration after MV surgery and maze results in LA size reduction irrespective of the energy source used. Compared to RF, the extension of ablation area produced by Cryo implies a structural LA remodelling affecting LA systolic function.

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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
3D volumes; atrial fibrillation; atrial strain; left atrium; mitral valve surgery; surgical ablation

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Vanky, FarkasLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland(Swepub:liu)farva32 (author)
Åström, MeriamLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Fysiologiska kliniken US(Swepub:liu)meras88 (author)
Linköpings universitetAvdelningen för diagnostik och specialistmedicin (creator_code:org_t)

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In:Clinical Physiology and Functional Imaging: WILEY43:6, s. 431-4401475-09611475-097X

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By the author/editor: Boano, Gabriella; Vanky, Farkas; Åström, Meriam

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