Early and late results of permanent atrial fibrillation ablation surgery in aortic valve and CABG patients.
OBJECTIVE
The study investigates the early and late results of permanent atrial fibrillation (AF) ablation surgery concomitant to coronary artery bypass grafting (CABG) and/or aortic valve (AV) surgery.


METHODS
Between February 2001 and April 2006, a selective group of 80 patients with permanent AF (median: 48 months [Perc25/75 24/110; range: 6 - 360 months]) underwent either bipolar (n = 60) or monopolar (n = 20) radiofrequency (RF) ablation procedures concomitant to CABG and/or AV surgery (CABG: n = 39; AV: n = 30; AV + CABG: n = 11). All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class early (3 +/- 1 months) and late after surgery (30 +/- 15 months). Data were analyzed exploratively.


RESULTS
Survival at 3 and 30 months was 98 % and 96 %, respectively. Stable SR could be documented in 73 % and 77 % of patients. Long-term AF before surgery and larger LA size were predictive for AF return after surgery ( P = 0.004 and P = 0.032, respectively). Neither age, gender, the application modus of the RF energy nor the underlying cardiac disease influenced the postoperative cardiac rhythm significantly. NYHA class improved significantly after surgery ( P < 0.0005), particularly when stable SR was achieved ( P = 0.049).


CONCLUSIONS
Preoperative permanent AF duration time and larger LA size are useful variables to predict the success rate of concomitant ablation surgery in CABG and/or AV patients. Further it could be demonstrated that established SR remained stable over time.
Geidel
S
S
Abteilung für Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany. s.geidel@asklepios.com
Lass
M
M
Krause
K
K
Betzold
M
M
Aslan
H
H
Boczor
S
S
Kuck
K-H
KH
Ostermeyer
J
J
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome