Treatment of atrial fibrillation with cryoablation and radiofrequent ablation - Dubrava University Hospital experience

    Authors

    Keywords

    atrial fibrillation, cryoablation, radiofrequency ablation

    DOI

    https://doi.org/10.15836/ccar2024.411

    Full Text

    **Introduction**: Atrial fibrillation (AF) is a common heart arrhythmia with a high prevalence and a growing number of cases globally. The global prevalence of AF is estimated to be around 60 million cases. The lifetime risk of developing AF is about 1 in 3–5 people after age 45. AF contributes to more than 8 million disability-adjusted life years. By 2050, the number of cases is expected to increase by 60%. (1) **Patients and Methods**: In our hospital we have performed 78 procedures since 2003. Formerly only radiofrequency ablation was performed. Program was reinitiated in October 2022. We have performed ablation in 31 patients until April 2024. These results will be presented in this abstract. 20 patients had chronic AF, and 11 patients paroxysmal AF. 65% of patients were male, with average age of 68 years. Average size of left atrium was 5 cm, and average duration of AF was 1.8 years. **Results**: We used AtriCure Cryoice cryoablation probe, and RF Isolator Long Synergy Clamp. 19 patients had contaminant mitral valve surgery, and cryo ablation was done in all of those patients with biatrial full lesion set. 12 patients had non mitral valve surgery (3 CABG, 3 AVR, 3 AVR+CABG, 1 AVR+aorta, 1 TVR) and radio frequent ablation was performed. All patients had LAA excluded. Every patient was administered amiodarone on day of surgery (1200 mg), followed by 200 mg orally daily. NOAC/Warfarin was continued until rhytmologist control visit after three months. 80% of patients were in synus rhythm at three months follow up. Patients remaining in AF were predominantly males with long lasting AF (more than 2.3 years). **Conclusion**: Atrial fibrillation presents a growing health issues and with new guidelines recommendations, having a surgical ablation program is mandatory. We have shown that the program in our institution is in line with results of all other world expert centres.

    Literature

    1. Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns HJGM, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024 September 29;45(36):3314–414. https://doi.org/10.1093/eurheartj/ehae176
    Cardiologia Croatica
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    Treatment of atrial fibrillation with cryoablation and radiofrequent ablation - Dubrava University Hospital experience

    Extended Abstract
    Issue11-12
    Published
    Pages411
    PDF via DOIhttps://doi.org/10.15836/ccar2024.411
    atrial fibrillation
    cryoablation
    radiofrequency ablation

    Authors

    Josip Varvodić*Dubrava University Hospital, Zagreb, Croatia
    Gloria ŠestanORCIDDubrava University Hospital, Zagreb, Croatia
    Davor BarićORCIDDubrava University Hospital, Zagreb, Croatia
    Daniel UnićORCIDDubrava University Hospital, Zagreb, Croatia
    Marko KušurinORCIDDubrava University Hospital, Zagreb, Croatia
    Nikola SliškovićDubrava University Hospital, Zagreb, Croatia
    Igor RudežORCIDDubrava University Hospital, Zagreb, Croatia

    *Correspondence email: josip.varvodic@gmail.com

    Full Text

    Introduction: Atrial fibrillation (AF) is a common heart arrhythmia with a high prevalence and a growing number of cases globally. The global prevalence of AF is estimated to be around 60 million cases. The lifetime risk of developing AF is about 1 in 3–5 people after age 45. AF contributes to more than 8 million disability-adjusted life years. By 2050, the number of cases is expected to increase by 60%. (1)

    Patients and Methods: In our hospital we have performed 78 procedures since 2003. Formerly only radiofrequency ablation was performed. Program was reinitiated in October 2022. We have performed ablation in 31 patients until April 2024. These results will be presented in this abstract. 20 patients had chronic AF, and 11 patients paroxysmal AF. 65% of patients were male, with average age of 68 years. Average size of left atrium was 5 cm, and average duration of AF was 1.8 years.

    Results: We used AtriCure Cryoice cryoablation probe, and RF Isolator Long Synergy Clamp. 19 patients had contaminant mitral valve surgery, and cryo ablation was done in all of those patients with biatrial full lesion set. 12 patients had non mitral valve surgery (3 CABG, 3 AVR, 3 AVR+CABG, 1 AVR+aorta, 1 TVR) and radio frequent ablation was performed. All patients had LAA excluded. Every patient was administered amiodarone on day of surgery (1200 mg), followed by 200 mg orally daily. NOAC/Warfarin was continued until rhytmologist control visit after three months. 80% of patients were in synus rhythm at three months follow up. Patients remaining in AF were predominantly males with long lasting AF (more than 2.3 years).

    Conclusion: Atrial fibrillation presents a growing health issues and with new guidelines recommendations, having a surgical ablation program is mandatory. We have shown that the program in our institution is in line with results of all other world expert centres.

    Literature

    1. 1.
      Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns HJGM, et al. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024 September 29;45(36):3314–414.DOI