[Ablation of permanent atrial fibrillation in cardiac surgery. Short-term and mid-term results].
BACKGROUND
Surgical ablation of atrial fibrillation is currently a simple procedure that can be done during cardiac surgery in most patients. A number of different energy sources now available allow to easily create ablation lines in the atria. We describe our experience during the previous three years.


METHODS
In 93 patients with cardiac problems treated with surgery and permanent atrial fibrillation (longer than 3 months), surgical ablation of the arrhythmia was done at the same time. Mean duration of the atrial fibrillation was 6 years (range 0.3 to 24 years). Mean (SD) preoperative size of the atrium as measured echocardiographically was 51.7 (8.8) mm (range 35 to 77 mm).


RESULTS
Five patients died in the hospital (5.3% in-hospital mortality). After a mean follow-up of 10 months, 83.8% of the patients had recovered and maintained sinus rhythm, and 16.1% of the patients remained in atrial fibrillation. A permanent pacemaker was implanted in 3 of these patients. Among the 82 patients followed for more than 6 months, the prevalence of sinus rhythm was 84.1%. Echocardiographically documented contractility in both atria was observed in 50% of the patients. Major complications related to the ablation procedure occurred in 3.5% of the patients, and consisted of a perivalvular leak 2 months after surgery, a circumflex artery spasm, and an atrio-esophageal fistula.


CONCLUSIONS
Surgical ablation of permanent atrial fibrillation is a simple procedure associated with low morbidity and mortality, and with recovery of sinus rhythm in most patients. The main problem with the procedure is the incidence of early postoperative arrhythmias.
Hornero Sos
Fernando
F
Servicio de Cirugía Cardíaca, Hospital General Universitario de Valencia, Valencia, Spain. hornero_fer@gva.es
Montero Argudo
José A
JA
Rodríguez Albarrán
Ignacio
I
Bueno Codoñer
María
M
Buendía Miñano
José
J
Gil Albarova
Oscar
O
García Fuster
Rafael
R
Cánovas López
Sergio
S
Payá Serrano
Rafael
R
Pérez Bosca
José L
JL
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors