Factors Predicting Success in Cryoablation of the Pulmonary Veins in Patients With Chronic Atrial Fibrillation

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Background This study was designed to investigate the factors predicting maintenance of sinus rhythm (SR) in patients with chronic atrial fibrillation (AF) undergoing cryoablation of the pulmonary veins (PV-cryo) during cardiac surgery. Methods and Results Seventy-seven patients with AF undergoing PV-cryo were recruited and divided into 2 groups based on whether they were able to maintain SR at discharge. The duration of AF (AF-D), left atrial dimension (LAd), and the average of the peak left atrial appendage outflow velocities (LAA-V) before surgery were determined for both groups. Group SR consisted of 54 patients (70%), and group AF consisted of 23 patients (30%). All patients with an AF-D ≤3 years, LAd <45 mm and LAA-V >40 cm/s were in group SR and all those with an AF-D >10 years and LAd ≥65 mm were in group AF. Only 71% of patients with a LAA-V ≤20 cm/s were in group AF. Conclusions Restoration of AF to SR by PV-cryo can be predicted from a knowledge of the AF-D, LAd and LAA-V. (Circ J 2004; 68: 999 - 1003)