Left Atrial Cryoablation Enhanced by Ganglionated Plexi Ablation in the Treatment of Atrial Fibrillation
Left Atrial Cryoablation Enhanced by Ganglionated Plexi Ablation in the Treatment of Atrial Fibrillation
The aim of our study was to investigate, whether enhancement of left atrial cryoablation by
 ablation of the autonomic nervous system of left atrium leads to influencing the outcomes of
 surgical treatment of atrial fibrillation in patients with structural heart disease
 undergoing open-heart surgery.
The observed patient file consisted of 100 patients, who have undergone a combined open-heart
 surgery at our department between July 2012 and December 2014. The patients were indicated
 for the surgical procedure due to structural heart disease, and suffered from paroxysmal,
 persistent, or long-standing persistent atrial fibrillation. In all cases, left atrial
 cryoablation was performed in the extent of isolation of pulmonary veins, box lesion,
 connecting lesion with mitral annulus, amputation of the left atrial appendage and connecting
 lesion of the appendage base with left pulmonary veins. Furthermore, thirty-five of the
 patients underwent mapping and radiofrequency ablation of ganglionated plexi, together with
 decision and ablation of the ligament of Marshall.
Inclusion Criteria:

 -  Indication for open-heart surgery (mitral valve disease and/or tricuspidal valve
 disease and/or aortic valve disease and/or coronary artery disease and/or other)

 -  Concomitant paroxysmal, persistent, long standing persistent atrial fibrillation

 -  Signing of the informed consent

 Exclusion Criteria:

 -  Age below 40 and over 80 years of age

 -  Left ventricular ejection fraction below 25%

 -  Left atrium diameter over 60mm

 -  Permanent atrial fibrillation

 -  Polymorbidity (Euroscore II over 10)

 -  Emergency surgery

 -  Renal insufficiency (creatinine over 200 umol/l)