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Ann Thorac Surg 2005;79:521-525
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Midterm Results of Pulmonary Vein Isolation for the Elimination of Chronic Atrial Fibrillation

Department of Cardiovascular Surgery, Hiroshima University, Graduate School of Medical Sciences, Hiroshima, Japan

Accepted for publication August 3, 2004.

^* Address reprint requests to Dr Sueda, Department of Cardiovascular Surgery, Hiroshima University, Graduate School of Medical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (E-mail: sueda{at}hiroshima-u.ac.jp).

BACKGROUND: This study aims to clarify midterm results of chronic atrial fibrillation elimination after pulmonary vein isolation and provides an evaluation of factors influencing results.

METHODS: Forty-nine patients were enrolled in this study. We performed a simple pulmonary vein isolation with the aid of cryoablation or radiofrequency ablation directed towards the left posterior remnant of the posterior left atrium. Results were evaluated using elimination rates of atrial fibrillation during the postoperative follow-up for > 12 months.We also examined factors influencing the recurrence of atrial fibrillation.

RESULTS: There were no hospital deaths or serious complications among the 49 patients. The total follow-up duration was 137.2 patient years. Forty-seven patients (96%) were followed with serial consultations, but 2 patients were dropped from this study because of changes in residence. Thirty-five of 49 patients (71.4%) showed regular sinus or nodal rhythms at discharge. In 4 patients atrial fibrillation recurred during the follow-up period, whereas in another 4 patients sinus rhythm was restored, although they showed atrial fibrillation at discharge. The cumulative elimination rate was 70.2% (33 of 47 patients), which was determined at the last follow-up period. Large left atrial diameters, a long history of atrial fibrillation, and low-voltage fibrillatory waves in V1 leads were preoperative indicators of recurrence of atrial fibrillation.

CONCLUSIONS: Pulmonary vein isolations were effective in the treatment of chronic atrial fibrillation patients and sinus rhythms were restored within the follow-up period.

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