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Linear Cryoablation of the Left Atrium Versus Pulmonary Vein Cryoisolation in Patients With Permanent Atrial Fibrillation and Valvular Heart Disease: Correlation of Electroanatomic Mapping and Long-Term Clinical Results

Gaita, Fiorenzo, Riccardi, Riccardo, Caponi, Domenico, Shah, Dipen, Garberoglio, Lucia, Vivalda, Laura, Dulio, Alessandro, Chiecchio, Andrea, Manasse, Eric, Gallotti, Roberto·2005·Circulation

Abstract

Background— The aim of this study was to clarify the role of pulmonary vein isolation (PVI) alone versus left atrial linear lesions in the treatment of permanent atrial fibrillation (AF) in patients with left atrial dilatation and valvular disease. The primary end point was to assess the persistence of sinus rhythm (SR) off antiarrhythmic drugs (AADs) at 2-year follow-up and to correlate clinical outcome with surgical results validated with electroanatomic mapping (EAM). Methods and Results— A total of 105 patients with permanent AF undergoing valve surgery were assigned to 3 different groups: in groups “U” and “7,” left atrial linear cryoablation was performed, whereas in group “PV” patients, anatomic cryoisolation of pulmonary veins only was performed. In groups U and 7, SR was achieved in 57% of patients, whereas it was achieved in 20% of PV patients during 2-year follow-up. In the first 51 patients, the ablation schemes were validated with EAM. The EAM showed that the U lesion was never obtained: in 59% of these patients, a complete 7 lesion was achieved instead; in the 7 group, a complete 7 lesion was present in 65% of patients, whereas a complete PVI was obtained in 71% of patients. Considering patients in whom a complete 7 lesion was demonstrated with the EAM, SR without AADs was achieved in 86% of patients, whereas only 25% of patients with complete PVI were in SR without AADs. Conclusions— In patients with permanent AF, left atrial dilatation and valvular heart disease linear lesions in the posterior region of the left atrium are more effective than PVI alone. With cryoablation, the surgical intent is fulfilled in only approximately 65% of the cases. Knowing the real anatomic and electrophysiological effects of surgical ablation is necessary to correctly interpret the clinical outcome.

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Metadata

Authors
Gaita, F., Riccardi, R., Caponi, D., Shah, D., Garberoglio, L., Vivalda, L., Dulio, A., Chiecchio, A., Manasse, E., & Gallotti, R.
Venue
Circulation
Published
2005-01-18
Volume
111
Issue
2
Pages
136-142
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W2008194065
Cited by
172
References
1
FWCI
11.36
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Linear Cryoablation of the Left Atrium Versus Pulmonary Vein Cryoisolation in Patients With Permanent Atrial Fibrillation and Valvular Heart Disease: Correlation of Electroanatomic Mapping and Long-Term Clinical Results. https://app.cochat.ai/papers/10.1161/01.cir.0000151310.00337.fa
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Gaita, F., Riccardi, R., Caponi, D., Shah, D., Garberoglio, L., Vivalda, L., Dulio, A., Chiecchio, A., Manasse, E., & Gallotti, R. (2005). Linear Cryoablation of the Left Atrium Versus Pulmonary Vein Cryoisolation in Patients With Permanent Atrial Fibrillation and Valvular Heart Disease: Correlation of Electroanatomic Mapping and Long-Term Clinical Results. Circulation. https://doi.org/10.1161/01.cir.0000151310.00337.fa

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