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KMID : 0364020140470040367
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Korean Journal of Thoracic and Cardiovascular Surgery
2014 Volume.47 No. 4 p.367 ~ p.372
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Efficacy of Cox Maze IV Procedure Using Argon-Based Cryoablation: A Comparative Study with N2O-Based Cryoablation
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Lee Kyung-Hak
Min Joon-Cheol
Kim Kyung-Hwan
Hwang Ho-Young
Kim Jun-Sung
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Abstract
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Background: We compared the mid-term results of the Cox maze IV procedure using argon-based cryoablation with a procedure using N2O-based cryoablation.
Methods: From May 2006 to June 2012, 138 patients (mean age, 58.2±11.0 years) underwent the Cox maze IV procedure. Eighty-five patients underwent the maze procedure using an N2O-based cryoprobe (group N), and 53 patients underwent the maze procedure using an argon-based cryoprobe (group A). Bipolar radiofrequency ablation was concomitantly used in 131 patients. The presence of atrial fibrillation immediately, 6 months, 1 year, and 2 years after surgery was compared.
Results: Early mortality occurred in 6 patients (4.3%). There were no differences in early mortality or postoperative complications between the two groups. Nineteen of 115 patients (16.5%) remained in atrial fibrillation at postoperative 12 months (14 of 80 patients (17.5%) in group N and 5 of 35 patients (14.3%) in group A, p=0.669). There were no differences in the number of patients who remained in atrial fibrillation at any of the time periods except in the immediate postoperative period. A multivariable analysis revealed that the energy source of cryoablation was not associated with the presence of atrial fibrillation at 1 year (p=0.862) and that a fine F wave (<0.1 mV) was the only risk factor predicting the presence of atrial fibrillation at 1 year (p<0.001, odds ratio=20.287).
Conclusion: The Cox maze IV procedure using an argon-based cryoprobe was safe and effective compared with the maze procedure using an N2O-based cryoprobe in terms of operative outcomes and the restoration of sinus rhythm for up to 2 years after surgery.
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KEYWORD
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Arrhythmia surgery, Arrhythmia, Atrial fibrillation, Ablation, Cryosurgery
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