Atrial function after left atrial epicardial cryoablation for atrial fibrillation in patients undergoing mitral valve surgery

PURPOSE: To explore the effects on atrial and ventricular function of restoring sinus rhythm (SR) after epicardial cryoablation and closure of the left atrial appendage (LAA) in patients with mitral valve disease and atrial fibrillation (AF) undergoing surgery.METHODS: Sixty-five patients with permanent AF were randomized to mitral valve surgery combined with left atrial epicardial cryoablation and LAA closure (ABL group, n = 30) or to mitral valve surgery alone (control group, n = 35). Two-dimensional and Doppler echocardiography were performed before and 6 months after surgery.RESULTS: At 6 months, 73% of the patients in the ABL group and 46% of the controls were in SR. Patients in SR at 6 months had a reduction in their left ventricular diastolic diameter while the left ventricular ejection fraction was unchanged. In patients remaining in AF, the left ventricular ejection fraction was lower than at baseline. The left atrial diastolic volume was reduced after surgery, more in patients with SR than AF. In patients in SR, the peak velocity during the atrial contraction and the reservoir function were lower in the ABL group than in the control group.CONCLUSIONS: In patients in SR, signs of atrial dysfunction were observed in the ABL but not the control group. Atrial dysfunction may have existed before surgery, but the difference between the groups implies that the cryoablation procedure and/or closure of the LAA might have contributed.

Bech-Hanssen, Odd,1956 (author)
Berglin, Eva,1947 (author)
Blomström, PerUppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi elektrokardiologi(Swepub:uu)perbloms (author)
Holmgren, Anders (author)
Jensen, Steen MUmeå universitet,Kardiologi(Swepub:umu)stje0001 (author)
Källner, GöranKarolinska Institutet (author)
Nilsson, LeifUppsala universitet,Thoraxkirurgi(Swepub:uu)lenil677 (author)
Thelin, StefanUppsala universitet,Thoraxkirurgi(Swepub:uu)stthe227 (author)
Karlsson, Thomas,1956 (author)
Edvardsson, Nils,1942Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine(Swepub:gu)xedvni (author)
Blomström-Lundqvist, CarinaUppsala universitet,Institutionen för medicinska vetenskaper,Kardiologi elektrokardiologi(Swepub:uu)carinabl (author)
Uppsala universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

In:Journal of Interventional Cardiac Electrophysiology: Springer Science+Business Media B.V.33:1, s. 85-911383-875X1572-8595

By the author/editor: Johansson, Birgi ...; Bech-Hanssen, Od ...; Berglin, Eva, 19 ...; Blomström, Per; Holmgren, Anders; Jensen, Steen M; show more...; Källner, Göran; Nilsson, Leif; Thelin, Stefan; Karlsson, Thomas ...; Edvardsson, Nils ...; Blomström-Lundqv ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

By the university: Umeå University; University of Gothenburg; Uppsala University; Karolinska Institutet

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