Event recorder monitoring to compare the efficacy of a left versus biatrial lesion set in patients undergoing concomitant surgical ablation for atrial fibrillation

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Event recorder monitoring to compare the efficacy of a left versus biatrial lesion set in patients undergoing concomitant surgical ablation for atrial fibrillation. / Pecha, Simon; Hartel, Friederike; Ahmadzade, Teymour; Aydin, Muhammet Ali; Willems, Stephan; Reichenspurner, Hermann; Wagner, Florian Mathias.

In: J THORAC CARDIOV SUR, Vol. 148, No. 5, 11.2014, p. 2161-2166.

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@article{042b1fad8f0341628d915d190611af48,
title = "Event recorder monitoring to compare the efficacy of a left versus biatrial lesion set in patients undergoing concomitant surgical ablation for atrial fibrillation",
abstract = "OBJECTIVES: Various lesion sets and subsequent success rates have been reported in patients receiving concomitant surgical ablation for atrial fibrillation. However, most of these results have been obtained by discontinuous monitoring. We report results using continuous event recorder rhythm monitoring to compare more accurately the efficacy of a left versus biatrial lesion set to treat patients with persistent atrial fibrillation.METHODS: Between July 2008 and December 2011, 66 patients with persistent or long-standing persistent atrial fibrillation underwent concomitant surgical atrial fibrillation ablation with a biatrial lesion set and subcutaneous event recorder implantation. The results and outcomes were compared with a propensity score-matched cohort of 66 patients with a left atrial lesion set and event recorder implantation. Event recorder interrogation was performed at 3, 6, and 12 months follow-up.RESULTS: The mean patient age was 70.2±7.4 years, and 70.3% were male. No major ablation-related complications occurred. One-year survival was 94.8% with no statistically significant differences between the 2 groups. The overall rate of freedom from atrial fibrillation was 57.3% and 64.4% after 3 and 12 months follow-up, respectively. Three months postoperatively, patients in the biatrial group had a slightly higher rate of freedom from atrial fibrillation (63.6% vs 52.3% P=.22), but it did not reach statistical significance. At 12 months follow-up, a statistically significant higher rate of freedom from atrial fibrillation was observed in patients with a biatrial lesion set (74.4% vs 55.8%; P=.026). The mean atrial fibrillation burden in all patients was 15.1%±12.5% in the biatrial group and 21.2%±14.4% in the left atrial group 12 months postoperatively (P=.03).CONCLUSIONS: Continuous rhythm monitoring by subcutaneous event recorder implantation was safe and feasible. In patients undergoing biatrial ablation, a statistically significant higher rate of freedom from atrial fibrillation was observed at 12 months follow-up.",
keywords = "Aged, Atrial Fibrillation/diagnosis, Catheter Ablation/adverse effects, Electrocardiography/instrumentation, Feasibility Studies, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Propensity Score, Recurrence, Retrospective Studies, Risk Factors, Telemetry/instrumentation, Time Factors, Treatment Outcome",
author = "Simon Pecha and Friederike Hartel and Teymour Ahmadzade and Aydin, {Muhammet Ali} and Stephan Willems and Hermann Reichenspurner and Wagner, {Florian Mathias}",
note = "Copyright {\textcopyright} 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.",
year = "2014",
month = nov,
doi = "10.1016/j.jtcvs.2014.02.061",
language = "English",
volume = "148",
pages = "2161--2166",
journal = "J THORAC CARDIOV SUR",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "5",

}

RIS

TY - JOUR

T1 - Event recorder monitoring to compare the efficacy of a left versus biatrial lesion set in patients undergoing concomitant surgical ablation for atrial fibrillation

AU - Pecha, Simon

AU - Hartel, Friederike

AU - Ahmadzade, Teymour

AU - Aydin, Muhammet Ali

AU - Willems, Stephan

AU - Reichenspurner, Hermann

AU - Wagner, Florian Mathias

N1 - Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

PY - 2014/11

Y1 - 2014/11

N2 - OBJECTIVES: Various lesion sets and subsequent success rates have been reported in patients receiving concomitant surgical ablation for atrial fibrillation. However, most of these results have been obtained by discontinuous monitoring. We report results using continuous event recorder rhythm monitoring to compare more accurately the efficacy of a left versus biatrial lesion set to treat patients with persistent atrial fibrillation.METHODS: Between July 2008 and December 2011, 66 patients with persistent or long-standing persistent atrial fibrillation underwent concomitant surgical atrial fibrillation ablation with a biatrial lesion set and subcutaneous event recorder implantation. The results and outcomes were compared with a propensity score-matched cohort of 66 patients with a left atrial lesion set and event recorder implantation. Event recorder interrogation was performed at 3, 6, and 12 months follow-up.RESULTS: The mean patient age was 70.2±7.4 years, and 70.3% were male. No major ablation-related complications occurred. One-year survival was 94.8% with no statistically significant differences between the 2 groups. The overall rate of freedom from atrial fibrillation was 57.3% and 64.4% after 3 and 12 months follow-up, respectively. Three months postoperatively, patients in the biatrial group had a slightly higher rate of freedom from atrial fibrillation (63.6% vs 52.3% P=.22), but it did not reach statistical significance. At 12 months follow-up, a statistically significant higher rate of freedom from atrial fibrillation was observed in patients with a biatrial lesion set (74.4% vs 55.8%; P=.026). The mean atrial fibrillation burden in all patients was 15.1%±12.5% in the biatrial group and 21.2%±14.4% in the left atrial group 12 months postoperatively (P=.03).CONCLUSIONS: Continuous rhythm monitoring by subcutaneous event recorder implantation was safe and feasible. In patients undergoing biatrial ablation, a statistically significant higher rate of freedom from atrial fibrillation was observed at 12 months follow-up.

AB - OBJECTIVES: Various lesion sets and subsequent success rates have been reported in patients receiving concomitant surgical ablation for atrial fibrillation. However, most of these results have been obtained by discontinuous monitoring. We report results using continuous event recorder rhythm monitoring to compare more accurately the efficacy of a left versus biatrial lesion set to treat patients with persistent atrial fibrillation.METHODS: Between July 2008 and December 2011, 66 patients with persistent or long-standing persistent atrial fibrillation underwent concomitant surgical atrial fibrillation ablation with a biatrial lesion set and subcutaneous event recorder implantation. The results and outcomes were compared with a propensity score-matched cohort of 66 patients with a left atrial lesion set and event recorder implantation. Event recorder interrogation was performed at 3, 6, and 12 months follow-up.RESULTS: The mean patient age was 70.2±7.4 years, and 70.3% were male. No major ablation-related complications occurred. One-year survival was 94.8% with no statistically significant differences between the 2 groups. The overall rate of freedom from atrial fibrillation was 57.3% and 64.4% after 3 and 12 months follow-up, respectively. Three months postoperatively, patients in the biatrial group had a slightly higher rate of freedom from atrial fibrillation (63.6% vs 52.3% P=.22), but it did not reach statistical significance. At 12 months follow-up, a statistically significant higher rate of freedom from atrial fibrillation was observed in patients with a biatrial lesion set (74.4% vs 55.8%; P=.026). The mean atrial fibrillation burden in all patients was 15.1%±12.5% in the biatrial group and 21.2%±14.4% in the left atrial group 12 months postoperatively (P=.03).CONCLUSIONS: Continuous rhythm monitoring by subcutaneous event recorder implantation was safe and feasible. In patients undergoing biatrial ablation, a statistically significant higher rate of freedom from atrial fibrillation was observed at 12 months follow-up.

KW - Aged

KW - Atrial Fibrillation/diagnosis

KW - Catheter Ablation/adverse effects

KW - Electrocardiography/instrumentation

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Propensity Score

KW - Recurrence

KW - Retrospective Studies

KW - Risk Factors

KW - Telemetry/instrumentation

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1016/j.jtcvs.2014.02.061

DO - 10.1016/j.jtcvs.2014.02.061

M3 - SCORING: Journal article

C2 - 24667024

VL - 148

SP - 2161

EP - 2166

JO - J THORAC CARDIOV SUR

JF - J THORAC CARDIOV SUR

SN - 0022-5223

IS - 5

ER -