PREOPERATIVE ASSESSMENT OF THE RISK ATRIAL FIBRILLATION RECURRENCE AFTER THE CRYOABLATION PROCEDURE AND CORRECTION OF MITRAL VALVE PATHOLOGY USING A PROGNOSTIC MODEL (PILOT STUDY)

Komarov Roman Nikolaevich, Matsuganov Denis Alekseevich, Nuzhdin Mikhail Dmitrievich

Aim. Checking the efficiency of the developed model in predicting the risk of recurrence of atrial fibrillation (AF) when selecting patients for the biatrial cryoablation procedure in combination with correction of mitral valve (MV) pathology in the early postoperative period. Methods. This pilot study included 16 patients with different forms of AF and mitral valve pathology. All patients the risk of recurrence of AF at the preoperative stage were evaluated. After that the final plan of surgical intervention was determined. Group 1 (n=8) consisted of patients who underwent a combined intervention – biatrial cryoablation procedure and correction of MV pathology, group 2 (n=8) – patients who underwent isolated correction of MV pathology. The rhythm was evaluated according to ECG data, the effect of the operation was evaluated according to TTE data. The duration of observation was 4 weeks. Results. Sinus rhythm was restored in 87.5% of patients in the MV+cryoablation group at the time of discharge, AF was preserved in 100% of cases in the MV group. Only the time of cardiopulmonary bypass was significantly differed, due the time to spent on cryoablation. It is worth noting longer need for temporary pacemaker in patients of the MV group of 8.5±5.07 versus 3.63±3.51 in the MV+cryoablation group (p=0.04). In the early postoperative period, in 100% of cases, AF paroxysm occurred among patients of the MV group: 8 (100%) patients compared with 2 (25.0%) patients of the MV+ablation group (p=0.008). Conclusion. Biatrial cryoablation procedure is a safe and effective procedure. According to the data of the early postoperative period, restore of the sinus rhythm was registered in 87.5% of cases. The model developed by us for assessing the risk of recurrence of AF, which allows selecting patients for this surgical intervention at the preoperative stage, has demonstrated its efficiency.

Keywords:atrial fibrillation, atrial cryoablation, mitral valve defect, risk prediction, AF recurrence.