Kardiochirurgia Drosłych
Argon cryoablation for the surgical treatment of atrial fibrillation – early experience and short-term results

Abstract
Background: Atrial fibrillation (AF) represents a disorder that increases the morbidity and mortality of patients undergoing heart surgery. The aim of this study was to evaluate a method of surgical argon cryoablation (CA) for the treatment of AF.
Methods: A retrospective review was performed on 80 patients undergoing CA with concomitant cardiac operations from June 2004 to July 2006.
Results: At discharge, 64 (80%) patients were free from AF,
61 (76.3%) were in normal SR, 2 (2.5%) had junction rhythm and 1 (1.2%) had atrial flutter. At early-A follow-up (3-6 months) 73.7% of patients were in SR. Atrial flutter was present in 6 (7.5%) patients. At late-B follow-up (9-12 months) 78.8% of patients had SR with the rest of the group remaining in AF. Two (2.5%) patients required permanent pacemaker implantation due to atrioventricular 3rd degree block.
Conclusion: This observational study documents the efficacy of CA for the treatment of AF.
Argon cryoablation technique provides good short-term results with a very short learning curve.



Introduction
Atrial fibrillation (AF) is present in 1-6% of patients undergoing cardiac surgery [1] and occurs in approximately 50% of patients undergoing mitral valve surgery [2]. If left untreated it is associated with increased morbidity and mortality due to adverse consequences of irregular rhythm and altered haemodynamics [3]. Loss of coordinated atrial contraction creates a predisposition for thrombus formation and increased thromboembolic risk [4].
To replace the traditional “cut and sew” Cox maze procedure different techniques that rely on alternate energy sources to create lines of conduction block have been developed. Apart from radiofrequency, microwave, ultrasound and laser, cryoablation (CA) has been developed to make continuous, transmural ablations [5].
The aim of this study was to evaluate our early experience with argon cryoablation for the treatment of atrial fibrillation.

Material and methods
A total of 80 patients, who underwent left sided surgical cryoablation for AF between June 2004 and July 2006, at our department, were retrospectively reviewed. Emergency procedures were excluded. Patients with a complete heart block or with history of flutter were excluded.
There were 41 (51.2%) patients with permanent AF,
16 (20%) patients with persistent AF and 23 (28.8%) with paroxysmal...


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