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Early outcomes of usage of cryoFORM® probe for cryomaze procedure in congenital heart surgery

Part of: Tetralogy of Fallot (TOF) Surgery Electrophysiology

Published online by Cambridge University Press:  29 September 2020

Firat H. Altin Open the ORCID record for Firat H. Altin [Opens in a new window] ,
Sevket Balli ,
Murat Cicek ,
Okan Yurdakok ,
Oktay Korun ,
Ahmet Sasmazel  and
Numan A. Aydemir
Firat H. Altin*
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Sevket Balli
Affiliation:
Paediatric Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Murat Cicek
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Okan Yurdakok
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Oktay Korun
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Ahmet Sasmazel
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
Numan A. Aydemir
Affiliation:
Paediatric Cardiovascular Surgery, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: Firat H. Altin, Tibbiye Cad. No:13 Uskudar, Istanbul, Turkey34668. Tel: + 90 (216) 542 44 44; Fax: + 90 (216) 418 96 49. E-mail: [email protected]
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Abstract

Objectives:

This study aimed to evaluate the early outcomes of patients who underwent a concomitant therapeutic maze procedure for congenital heart surgery.

Materials and Methods:

Between 2019 and 2020, eight patients underwent surgical cryoablation by using the same type of cryoablation probe.

Results:

Three patients had atrial flutter, two had Wolf–Parkinson–White syndrome, two intra-atrial reentrant tachycardia, and one had atrial fibrillation. Four patients underwent electrophysiological study. Preoperatively, one patient was on 3, two were on 2, five were on 1 antiarrhythmic drug. Six patients underwent right atrial maze and two underwent bilateral atrial maze. Five out of six right atrial maze patients underwent right atrial reduction. Nine different lesion sets were used. Some of the lesions were combined and applied as one lesion. In Ebstein’s anomaly patients, the lesion from coronary sinus to displaced tricuspid annulus was delicately performed. The single ventricle patient with heterotaxy had junctional rhythm at the time of discharge and was the only patient who experienced atrial extrasystoles 2 months after discharge. Seven of the eight patients were on sinus rhythm. No patient needed permanent pacemaker placement.

Conclusion:

Cryomaze procedure can be applied in congenital heart diseases with acceptable arrhythmia-free rates by selecting the appropriate materials and suitable lesion sets. The application of cryomaze in heterotaxy patients can be challenging due to differences in the conduction system and complex anatomy. Consensus with the electrophysiology team about the choice of the right–left or biatrial maze procedure is mandatory for operational success.

Keywords

Arrhythmiacongenital heart diseasecryoablationmaze procedurecardiac surgery
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1874 - 1879
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Giamberti, A, Pluchinotta, FR, Chessa, M, et al. Surgery for supraventricular tachycardia and congenital heart defects: long-term efficacy of the combined approach in adult patients. Europace 2017; 19: 1542–1548.Google ScholarPubMed
Somerville, J. Management of adults with congenital heart disease: an increasing problem. Annu Rev Med 1997; 48: 283–293.10.1146/annurev.med.48.1.283CrossRefGoogle ScholarPubMed
Khairy, P, Balaji, S. Cardiac arrhythmias in congenital heart diseases. Indian Pacing Electrophysiol J 2009; 9: 299–317.Google ScholarPubMed
Labombarda, F, Hamilton, R, Shohoudi, A, et al. Increasing prevalence of atrial fibrillation and permanent atrial arrhythmias in congenital heart disease. J Am Coll Cardiol 2017; 70: 857–865.10.1016/j.jacc.2017.06.034CrossRefGoogle ScholarPubMed
Walsh, E, Cecchin, F. Congenital heart disease for the adult cardiologist: arrhythmias in adult patients with congenital heart disease. Circulation 2007; 115: 534–545.10.1161/CIRCULATIONAHA.105.592410CrossRefGoogle Scholar
Walsh, E. Interventional cardiac electrophysiology in patients with congenital heart disease. Circulation 2007; 115: 3224–3234.10.1161/CIRCULATIONAHA.106.655753CrossRefGoogle ScholarPubMed
Kirsh, JA, Walsh, EP, Triedman, JK. Prevalence of and risk factors for atrial fibrillation and intra-atrial reentrant tachycardia among patients with congenital heart disease. Am J Cardiol 2002; 90: 338–340.10.1016/S0002-9149(02)02480-3CrossRefGoogle ScholarPubMed
Triedman, JK, Bergau, DM, Saul, JP, Epstein, MR, Walsh, EP. Efficacy of radiofrequency ablation for control of intraatrial reentrant tachycardia in patients with congenital heart disease. J Am Coll Cardiol 1997; 30: 1032–1038.CrossRefGoogle ScholarPubMed
Mavroudis, C, Stulak, JM, Ad, N, et al. Prophylactic atrial arrhythmia surgical procedures with congenital heart operations: reviews and recommendations. Ann Thorac Surg 2015; 99: 352–359.CrossRefGoogle ScholarPubMed
Schroeter, T, Misfeld, M. Characteristics of the new AtriCure cryoFORM® cryoablation probe for the surgical treatment of cardiac arrhythmias. Expert Rev Med Devices 2017; 14: 255–262.10.1080/17434440.2017.1309972CrossRefGoogle ScholarPubMed
Gillinov, MA. Surgical treatment of atrial fibrillation. J Atr Fibrillation 2008; 1: 19.Google ScholarPubMed
Cox, JL, Schuessler, RB, Lappas, DG, et al. An 8 1/2-year clinical experience with surgery for atrial fibrillation. Ann Surg 1996; 224: 267–273.10.1097/00000658-199609000-00003CrossRefGoogle ScholarPubMed
Mavroudis, C, Deal, BJ. Prophylactic arrhythmia surgery in association with congenital heart disease. Transl Pediatr 2016; 5: 148–159.10.21037/tp.2016.06.04CrossRefGoogle ScholarPubMed
Theodoro, DA, Danielson, GK, Porter, CJ, Warnes, CA. Right-sided maze procedure for right atrial arrhythmias in congenital heart disease. Ann Thorac Surg 1998; 65: 149–154.10.1016/S0003-4975(97)01193-4CrossRefGoogle ScholarPubMed
Karamlou, T, Silber, I, Lao, R, et al. Outcomes after late reoperation in patients with repaired tetralogy of Fallot: the impact of arrhythmia and arrhythmia surgery. Ann Thorac Surg 2006; 81: 1786–1793.10.1016/j.athoracsur.2005.12.039CrossRefGoogle ScholarPubMed
Giamberti, A, Chessa, M, Foresti, S, et al. Combined atrial septal defect surgical closure and irrigated radiofrequency ablation in adult patients. Ann Thorac Surg 2006; 82: 1327–1331.10.1016/j.athoracsur.2006.05.010CrossRefGoogle ScholarPubMed
Giamberti, A, Chessa, M, Abella, R, et al. Surgical treatment of arrhythmias in adults with congenital heart defects. Int J Cardiol 2008; 129: 37–41.10.1016/j.ijcard.2007.06.019CrossRefGoogle ScholarPubMed
Mavroudis, C, Stulak, JM, Siegel, A, et al. Prophylactic atrial arrhythmia surgical procedures with congenital heart operations: review and recommendations. Ann Thorac Surg 2015; 99: 352–359.10.1016/j.athoracsur.2014.07.026CrossRefGoogle ScholarPubMed
Ho, SY, Seo, JW, Brown, NA, Cook, AC, Fagg, NL, Anderson, RH. Morphology of the sinus node in human and Mouse hearts with isomerism of the atrial appendages. Br Heart J 1995; 74: 437–442.10.1136/hrt.74.4.437CrossRefGoogle ScholarPubMed
Ho, SY, Fagg, N, Anderson, RH, Cook, A, Allan, L. Disposition of the atrioventricular conduction tissues in the heart with isomerism of the atrial appendages: its relation to congenital complete heart block. J Am Coll Cardiol 1992; 20: 904–910.10.1016/0735-1097(92)90191-OCrossRefGoogle ScholarPubMed
Chen, SS, Dimopoulos, K, Sheehan, FH, Gatzoulis, MA, Kilner, PJ. Physiologic determinants of exercise capacity in patients with different types of right-sided regurgitant lesions: Ebstein’s malformation with tricuspid regurgitation and repaired tetralogy of Fallot with pulmonary regurgitation. Int J Cardiol 2016; 205: 1–5.CrossRefGoogle Scholar
Rathore, KS, Agrawal, SK, Kapoor, A. Restrictive physiology in tetralogy of Fallot: exercise and arrhythmogenesis. Asian Cardiovasc Thorac Ann 2006; 14: 279–283.CrossRefGoogle ScholarPubMed
Corcia, MCG, Walsh, EP, Emani, S. Long-term results of atrial maze surgery in patients with congenital heart disease. Europace 2019; 21: 1345–1352.CrossRefGoogle Scholar
Prasad, SM, Maniar, HS, Camillo, CJ, et al. The Cox maze III procedure for atrial fibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures. J Thorac Cardiovasc Surg 2003; 126: 1822–1828.10.1016/S0022-5223(03)01287-XCrossRefGoogle ScholarPubMed
Yaghoubi, A, Rostamzadeh, M, Pezeshkian, M, Parvizi, R, Imani, S. Evaluation of early and intermediate outcomes of Cryo-Maze procedure for atrial fibrillation. J Cardiovasc Thorac Res 2013; 5: 55–59.Google ScholarPubMed
Aupperle, H, Doll, N, Walther, T, et al. Ablation of atrial fibrillation and esophageal injury: effects of energy source and ablation technique. J Thorac Cardiovasc Surg 2005; 130: 1549–1554.10.1016/j.jtcvs.2005.06.052CrossRefGoogle ScholarPubMed
Khairy, P, Chauvet, P, Lehmann, J, et al. Lower incidence of thrombus formation with cryoenergy versus radiofrequency catheter ablation. Circulation 2003; 107: 2045–2050.10.1161/01.CIR.0000058706.82623.A1CrossRefGoogle ScholarPubMed
Gillinov, AM, McCarthy, PM, Pettersson, G, Lytle, BW, Rice, TW. Esophageal perforation during left atrial radiofrequency ablation: is the risk too high? J Thorac Cardiovasc Surg 2003; 125: 836–842.Google Scholar
Gillinov, AM, Pettersson, G, Rice, TW. Esophageal injury during radiofrequency ablation for atrial fibrillation. J Thorac Cardiovasc Surg 2001; 122: 1239–1240.CrossRefGoogle ScholarPubMed
Anguera, I, Dallaglio, P, Macías, R, et al. Long-term outcome after ablation of right atrial tachyarrhythmias after the surgical repair of congenital and acquired heart disease. Am J Cardiol 2015; 115: 1705–1713.10.1016/j.amjcard.2015.03.017CrossRefGoogle ScholarPubMed
Andrade, JG, Khairy, P, Verma, A, et al. Early recurrence of atrial tachyarrhythmias following radiofrequency catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol 2012; 35: 106–116.10.1111/j.1540-8159.2011.03256.xCrossRefGoogle ScholarPubMed
Ho, SY, Sánchez-Quintana, D. The importance of atrial structure and fibers. Clin Anat 2009; 22: 52–63.CrossRefGoogle Scholar
Platonov, PG, Mitrofanova, L, Ivanov, V, Ho, SY. Substrates for intra-atrial and interatrial conduction in the atrial septum: anatomical study on 84 human hearts. Heart Rhythm 2008; 5: 1189–1195.10.1016/j.hrthm.2008.04.025CrossRefGoogle Scholar
Koh, M, Uemura, H, Kada, A, Kagisaki, K, Hagino, I, Yagihara, T. Chronologic changes in P-wave characteristics after the Fontan procedure: the effect of surgical modification. J Thorac Cardiovasc Surg 2010; 140: 137–143.10.1016/j.jtcvs.2010.03.014CrossRefGoogle Scholar
Uemura, H. Surgical aspects of atrial arrhythmia: right atrial ablation and antiarrhythmic surgery in congenital heart disease. Herzschrittmacherther Elektrophysiol 2016; 27: 137–142.10.1007/s00399-016-0434-6CrossRefGoogle Scholar
Khairy, P, Van Hare, GF, Balaji, S, et al. PACES/HRS Expert Consensus Statement on the recognition and management of arrhythmias in adult congenital heart disease. Heart Rhythm 2014; 11: e102–e165.10.1016/j.hrthm.2014.05.009CrossRefGoogle ScholarPubMed
Hernandez-Madrid, A, Paul, T, Abrams, D, et al. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace 2018; 20: 1719–1753.10.1093/europace/eux380CrossRefGoogle Scholar