Mortality after cardiac surgery with or without microwave ablation in patients with permanent atrial fibrillation.
OBJECTIVE
The surgical treatment of atrial fibrillation (AF) by Cox and other ablation methods shows a 50-90% conversion rate to sinus rhythm. However, to date no study has addressed the influence of ablation on the mortality rate.


METHODS
The perioperative and postoperative mortalities of 210 consecutive patients with permanent AF was investigated for up to two years after cardiac surgery with (n = 111) or without (n = 99) endocardial microwave ablation within the framework of a prospective register study. All patients were followed up.


RESULTS
In the ablation group, one patient (0.9%) died perioperatively, seven died during the first year of follow up (6.3%), and nine in the second year of follow up (8.1%). In the control group, five patients died perioperatively (5.1%), 12 died in the first year of follow up (12.1%), and 22 in the second year of follow up (22.2%). During the two-year follow up period, significantly more patients died in the control group than in the ablation group (Log-Rank test: p = 0.0051).


CONCLUSIONS
The results of this register study showed that among patients with permanent AF who underwent cardiac surgery with ablation, mortality was significantly lower than in those who underwent comparable surgery but without ablation. The marked difference in mortality was essentially based on the typical clinical consequences of AF (e.g. thromboembolic complications, cardiac arrhythmias and bleeding complications due to anticoagulation therapy), which occurred less often in the ablation group.
Knaut
Michael
M
Department of Cardiac Surgery, University of Technology Dresden, Dresden, Germany. M.Weber@herzzentrum-dresden.com
Tugtekin
Sems M
SM
Spitzer
Stefan
S
Jung
Friedrich
F
Matschke
Klaus
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000401:mortality* / Q000628:therapy*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents