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Efficacy of Cox-maze IV Procedure Using Argon-Based Cryoablation: Comparative Study with N₂O-Based Cryoablation
Kyung-Hwan Kim1, Ho Young Hwang1, Jun Sung Kim2, Kyung Hak Lee1.
1Seoul National University Hospital, Seoul, Korea, Republic of, 2Seoul National University Bundang Hospital, Seongnam, Korea, Republic of.
OBJECTIVE:
We compared mid-term results of Cox-maze IV procedure using argon-based cryoablation with those using N₂O-based cryoablation.
METHODS:
From May 2006 to June 2012, 138 patients (58.2±11.0 years) underwent Cox maze IV procedure. Eighty five patients underwent maze using N₂O-based cryoprobe (group N) and 53 patients underwent maze procedure using argon-based cryoprobe (group A). Bipolar radiofrequency ablation was concomitantly used in 117 patients. Patients in the group N were older than those in the group A (61.2±11.3 years vs 56.4±10.4 years, p=0.011). Presence of AF at early postoperative days, 3 months, 6 months, 1 year and 2 years after surgery were compared. Follow-up duration was 39 ± 24 months.
RESULTS:
Early mortality occurred in 6 patients (4.3%). There were no differences in early mortality and postoperative complications between the 2 groups. Nineteen of 115 patients (16.5%) remained in AF at postoperative 12 months (11 of 80 patients [13.8%] in the group N and 4 of 35 patients [11.4%] in the group A, p>0.999). There were no differences in patients remained as AF at all time periods. Multivariable analyses revealed that energy source of cryoablation did not associated with a presence of AF at 1 year (p=0.862), and fine F wave (<0.1mV) was the only risk factor predicting presence of AF at 1 year (p<0.001, odds ratio=20.287 [4.189-96.331]).
CONCLUSIONS:
Cox maze IV procedure using argon-based cryoprobe was safe and effective compared with maze procedure using N₂O-based cryoprobe in terms of restoration of sinus rhythm until 2 years after surgery.
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