Lesion durability found during mandated percutaneous catheter ablation after surgical cryo-ablation for treatment of non-paroxysmal atrial fibrillation

Autor: Alan Bulava, Aleš Mokráček, Petr Němec, Dan Wichterle, Pavel Osmančík, Petr Budera, Petr Kačer, Linda Vetešková, Tomáš Skála, Petr Šantavý, Jan Chovančík, Piotr Branny, Vitalii Rizov, Miroslav Kolesár, Iva Šafaříková, Marian Rybář, SURHYB Trial Investigators
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 19, Iss 1, Pp 1-10 (2024)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-024-02889-3
Popis: Abstract Objectives Current recommendations support surgical treatment of atrial fibrillation (AF) in patients indicated for cardiac surgery. These procedures are referred to as concomitant and may be carried out using radiofrequency energy or cryo-ablation. This study aimed to assess the electrophysiological findings in patients undergoing concomitant cryo-ablation. Methods Patients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement were included in the trial if concomitant cryo-ablation was part of the treatment plan according to current guidelines. The patients reported in this study were assigned to undergo staged percutaneous radiofrequency catheter ablation (PRFCA), i.e., hybrid treatment, as a part of the SURHYB trial protocol. Results We analyzed 103 patients who underwent PRFCA 105 ± 35 days after surgery. Left and right pulmonary veins (PVs) were found isolated in 65 (63.1%) and 63 (61.2%) patients, respectively. The LA posterior wall isolation and mitral isthmus conduction block were found in 38 (36.9%) and 18 (20.0%) patients, respectively. Electrical reconnections (gaps) in the left PVs were more often localized superiorly than inferiorly (57.9% vs. 26.3%, P = 0.005) and anteriorly than posteriorly (65.8% vs. 31.6%, P = 0.003). Gaps in the right PVs were more equally distributed anteroposteriorly but dominated in superior segments (72.5% vs. 40.0%, P = 0.003). There was a higher number of gaps on the roof line compared to the inferior line (131 (67.2%) vs. 67 (42.2%), P
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