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BACKGROUND Cox-maze procedures are safe methods of restoring sinus rhythm (SR) in patients with atrial fibrillation (AF), and are often performed concomitant with mitral valve (MV) surgery. Atrial linear scars are achieved using Cryothermy (Cryo) or radiofrequency (RF) techniques. It is unclear how these energy sources differ in terms of effects on late left atrial (LA) reverse remodeling. We used 3-dimensional echocardiography (3DE) to compare the impact of Cryo and RFprocedures on LA size and function one year after Cox-maze IV ablation concomitant with MV surgery. METHODS Seventy-two patients with MV disease and AF were randomized to Cryo (n = 35) or RF (n = 37) ablation. Another 33 patients were enrolled according to the protocol without ablation (NoMaze). All patients underwent echocardiogram before and one year after surgery. Between-group differences were evaluated using the Student’s paired t-test. Fisher’s analysis was used for categorical data. RESULTS Forty-two ablated patients recovered sinus rhythm (SR) one year post-surgery, and had comparable left and right systolic ventricular function and a mean LA size reduction of 23% (LA volume index decreased from 66 ± 24 to 54 ± 13 ml/m2; p = 0.004). The 3DE extracted reservoir and booster function were higher after RF (37 ± 10% vs. 26 ± 6%; p |
