Factors predicting success in cryoablation of the pulmonary veins in patients with chronic atrial fibrillation

Background This study was designed to investigate the factors predicting maintenance of sinus rhythm (SR) in patients with chronic atrial fibrillation (AF) undergoing cryoablation of the pulmonary veins (PV-cryo) during cardiac surgery. Methods and Results Seventy-seven patients with AF undergoing PV-cryo were recruited and divided into 2 groups based on whether they were able to maintain SR at discharge. The duration of AF (AF-D), left atrial dimension (LAd), and the average of the peak left atrial appendage outflow velocities (LAA-V) before surgery were determined for both groups. Group SR consisted of 54 patients (70%), and group AF consisted of 23 patients (30%). All patients with an AF-D less than or equal to3 years, LAd <45 mm and LAA-V >40 cm/s were in group SR and all those with an AF-D >10 years and LAd greater than or equal to65 mm were in group AF. Only 71% of patients with a LAA-V less than or equal to20 cm/s were in group AF. Conclusions Restoration of AF to SR by PV-cryo can be predicted from a knowledge of the AF-D, LAd and LAA-V.