Mack Charles A, Milla Federico, Ko Wilson, Girardi Leonard N, Lee Leonard Y, Tortolani Anthony J, Mascitelli Justin, Krieger Karl H, Isom O Wayne
Department of Cardiothoracic Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10021, USA.
Circulation. 2005 Aug 30;112(9 Suppl):I1-6. doi: 10.1161/CIRCULATIONAHA.104.524363.
The development of ablative energy sources has simplified the surgical treatment of atrial fibrillation (AF) during concomitant cardiac procedures. We report our results using argon-based endocardial cryoablation for the treatment of AF in patients undergoing concomitant cardiac procedures.
Sixty-three patients with AF who were undergoing concomitant cardiac procedures had the same left atrial endocardial lesion set using a flexible argon-based cryoablative device. Mean age was 65.1+/-1.3 years. Sixty-two percent had permanent AF, whereas 38% had paroxysmal AF. Mean duration of AF was 30.5+/-4.8 months. Mean left atrial diameter was 5.5+/-0.1 cm. Mean ejection fraction was 45+/-1.4%. All endocardial lesions were performed for 1 minute once tissue temperature reached -40 degrees C. Follow-up echocardiograms were obtained to determine freedom from AF. Kaplan-Meier analysis demonstrated an 88.5% freedom from AF rate at 12 months. Ablation time was 16.8+/-0.6 minutes. There were no in-hospital deaths and no strokes. Twelve patients (19%) required postoperative permanent pacemaker placement.
Cryoablation using this flexible argon-based device for the treatment of AF during concomitant cardiac procedures was safe and effective, with 88.5% of patients free from AF at 12 months.
消融能源的发展简化了在同期心脏手术中房颤（AF）的外科治疗。我们报告了使用基于氩气的心内膜冷冻消融术治疗同期心脏手术患者房颤的结果。
63例接受同期心脏手术的房颤患者使用一种基于氩气的可弯曲冷冻消融装置进行了相同的左心房心内膜损伤设置。平均年龄为65.1±1.3岁。62%为永久性房颤，38%为阵发性房颤。房颤平均持续时间为30.5±4.8个月。平均左心房直径为5.5±0.1 cm。平均射血分数为45±1.4%。一旦组织温度达到-40℃，所有心内膜损伤均持续1分钟。通过随访超声心动图确定房颤消失情况。Kaplan-Meier分析显示12个月时房颤消失率为88.5%。消融时间为16.8±0.6分钟。无院内死亡和卒中发生。12例患者（19%）术后需要植入永久性起搏器。
在同期心脏手术中使用这种基于氩气的可弯曲装置进行冷冻消融治疗房颤安全有效，12个月时88.5%的患者房颤消失。
