초록접수 현황
| 16F-186 | 구연 발표 |
Randomized Trial of Concomitant Maze Procedure using Nitrous Oxide-based Versus Argon-based Cryoablation in Patients with Persistent Atrial Fibrillation.
Ji Young Park, Pyo Won Park, Young Tak Lee, Wook Sung Kim, Kiick Sung, Dong Seop Jeong, Yang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : The aim of this study was to evaluate the early outcomes of concomitant maze procedure using nitrous oxide-based cryoablation (N2O group) compared to argon-based cryoablation (Argon group) in patients with persistent atrial fibrillation (AF).
Methods : Sixty patients undergoing heart valve surgery were randomized to receive a concomitant maze procedure using N2O-based cryoablation (n=30) or argon-based cryoablation (n=30) for persistent AF. Patients were followed up at 3, 6 and 12 months by electrocardiography, 24-hr Holter monitoring and transthoracic echocardiography. Atrial arrhythmia events included AF recurrence, the need of antiarrhythmic drug for symptoms, permanent pacemaker insertion, and the need for cardioversion. An intention-to-treat approach was used.
Results : There was no significant intergroup difference in terms of preoperative parameters, in-hospital morbidity and mortality. The average total ablation time was similar between groups (21.1 ± 3.1minutes in the N2O group versus 21.1 ± 3.6minutes in the Argon group; P = 0.990). During one-year follow up, normal sinus rhythm was maintained in 24 patients in the N2O group and 26 patients in the Argon group (80% versus 86.7%, P = 0.488). Freedom from atrial arrhythemia event at 12 months were similar between groups (P = 0.243). The N2O group was an independent predictor of early (< 3 months postoperative) recovery of atrial mechanical contraction (odds ratio 6.1, 95% CI 1.1 to 34.9, P = 0.043), however, the difference disappeared at postoperative 12 months.
Conclusion : Both nitrous oxide and argon-based cryoablation have similar mid-term sinus conversion rate. Early left atrial contractile activity tends to return earlier in nitrous oxide cryoablation.
Methods : Sixty patients undergoing heart valve surgery were randomized to receive a concomitant maze procedure using N2O-based cryoablation (n=30) or argon-based cryoablation (n=30) for persistent AF. Patients were followed up at 3, 6 and 12 months by electrocardiography, 24-hr Holter monitoring and transthoracic echocardiography. Atrial arrhythmia events included AF recurrence, the need of antiarrhythmic drug for symptoms, permanent pacemaker insertion, and the need for cardioversion. An intention-to-treat approach was used.
Results : There was no significant intergroup difference in terms of preoperative parameters, in-hospital morbidity and mortality. The average total ablation time was similar between groups (21.1 ± 3.1minutes in the N2O group versus 21.1 ± 3.6minutes in the Argon group; P = 0.990). During one-year follow up, normal sinus rhythm was maintained in 24 patients in the N2O group and 26 patients in the Argon group (80% versus 86.7%, P = 0.488). Freedom from atrial arrhythemia event at 12 months were similar between groups (P = 0.243). The N2O group was an independent predictor of early (< 3 months postoperative) recovery of atrial mechanical contraction (odds ratio 6.1, 95% CI 1.1 to 34.9, P = 0.043), however, the difference disappeared at postoperative 12 months.
Conclusion : Both nitrous oxide and argon-based cryoablation have similar mid-term sinus conversion rate. Early left atrial contractile activity tends to return earlier in nitrous oxide cryoablation.
책임저자: Pyo Won Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Ji Young Park, E-mail : chunhaa@naver.com