title: Early and late results of permanent atrial fibrillation ablation surgery in aortic valve and CABG patients.
abstract: 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.
authors.affiliation: Abteilung für Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany. s.geidel@asklepios.com
authors.forename: S
authors.initials: S
authors.lastname: Geidel
authors.forename: M
authors.initials: M
authors.lastname: Lass
authors.forename: K
authors.initials: K
authors.lastname: Krause
authors.forename: M
authors.initials: M
authors.lastname: Betzold
authors.forename: H
authors.initials: H
authors.lastname: Aslan
authors.forename: S
authors.initials: S
authors.lastname: Boczor
authors.forename: K-H
authors.initials: KH
authors.lastname: Kuck
authors.forename: J
authors.initials: J
authors.lastname: Ostermeyer
mesh_terms: 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