Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: a 9-year, single-center experience
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Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: a 9-year, single-center experience. / Pecha, Simon; Schäfer, Timm; Subbotina, Irina; Ahmadzade, Teymour; Reichenspurner, Hermann; Wagner, Florian Mathias.
In: J THORAC CARDIOV SUR, Vol. 148, No. 2, 08.2014, p. 428-433.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: a 9-year, single-center experience
AU - Pecha, Simon
AU - Schäfer, Timm
AU - Subbotina, Irina
AU - Ahmadzade, Teymour
AU - Reichenspurner, Hermann
AU - Wagner, Florian Mathias
N1 - Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - OBJECTIVES: Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients.METHODS: From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation.RESULTS: The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter (P = .0019), AF duration (P = .018), and immediate postoperative SR (P < .001). Regarding only patients with persistent or longstanding-persistent AF, those with biatrial lesions had significantly greater rates of conversion to SR than those with solitary left atrial ablation (SR, 64.9% vs 51.4%; P = .044) after 12 months.CONCLUSIONS: The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.
AB - OBJECTIVES: Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients.METHODS: From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation.RESULTS: The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter (P = .0019), AF duration (P = .018), and immediate postoperative SR (P < .001). Regarding only patients with persistent or longstanding-persistent AF, those with biatrial lesions had significantly greater rates of conversion to SR than those with solitary left atrial ablation (SR, 64.9% vs 51.4%; P = .044) after 12 months.CONCLUSIONS: The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.
KW - Aged
KW - Atrial Fibrillation/diagnosis
KW - Catheter Ablation/adverse effects
KW - Coronary Artery Bypass
KW - Disease-Free Survival
KW - Electrocardiography, Ambulatory
KW - Female
KW - Germany
KW - Heart Atria/physiopathology
KW - Heart Valve Prosthesis Implantation
KW - Hospital Mortality
KW - Humans
KW - Male
KW - Middle Aged
KW - Pulmonary Veins/physiopathology
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.jtcvs.2013.08.074
DO - 10.1016/j.jtcvs.2013.08.074
M3 - SCORING: Journal article
C2 - 24139897
VL - 148
SP - 428
EP - 433
JO - J THORAC CARDIOV SUR
JF - J THORAC CARDIOV SUR
SN - 0022-5223
IS - 2
ER -
