title: Restoring sinus rhythm in patients with previous pacemaker implantation submitted to cardiac surgery and concomitant surgical ablation of atrial fibrillation.
abstract: OBJECTIVE
  Some patients submitted to cardiac surgery have concomitant atrial fibrillation and a previously implanted pacemaker. Because it is unknown if there is any potential for these patients to reassume a regular rate sinus rhythm after ablation of atrial fibrillation, we reviewed the results of all patients with pacemaker enrolled in the Registry of Atrial Fibrillation.
  
  
  METHODS
  Thirty-six patients were included in this study. Twenty-six had valve disease, seven had coronary disease and three had congenital heart disease. They were submitted concomitantly to ablation of atrial fibrillation using biatrial approaches (seven patients), left sided (27), or right sided (three patients). Thirty-three hospital survivors had a mean follow-up of 18 months, and a maximum of 25 months.
  
  
  RESULTS
  At 1 year (n=21), patients' rhythm was sinus non-pacing dependent (52%), sinus pacing-dependent (14%), and atrial fibrillation (14%). At 2 years (n=14), patients' rhythm was sinus non-pacing dependent (57%) and atrial fibrillation (43%). The only factor that may have had impact on the recovery of sinus rhythm at 1 year was the small size of the left atrium (p=0.05).
  
  
  CONCLUSIONS
  We conclude that in a significant number of patients, having a pacemaker before surgery does not preclude sinus rhythm recovery after a cardiac operation and ablation for concomitant atrial fibrillation.
authors.affiliation: Santa Cruz Hospital, Carnaxide, Portugal.
authors.forename: Marta P
authors.initials: MP
authors.lastname: Marques
authors.forename: João Q
authors.initials: JQ
authors.lastname: Melo
authors.forename: Michel
authors.initials: M
authors.lastname: Knaut
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
authors.forename: Stefano
authors.initials: S
authors.lastname: Benussi
authors.forename: Mathew R
authors.initials: MR
authors.lastname: Williams
authors.forename: Fernando
authors.initials: F
authors.lastname: Hornero
mesh_terms: D000368:Aged; D001146:Arrhythmia, Sinus / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D016896:Treatment Outcome