title: Early recurrence is a predictor of late failure in surgical ablation of atrial fibrillation.
abstract: We sought to determine if early recurrence of atrial fibrillation (AF) after surgical ablation is a risk factor of late failure. Between February 2004 to May 2009, 106 patients underwent surgical ablation of concomitant permanent AF with radiofrequency. Operations primarily consisted of valve surgery in 85% of patients. Hospital mortality was 2.8% (n = 3). The median follow-up was 37 months (interquartile rank 12-77), and was complete in 99% of patients. Freedom from AF was 82%, 76% and 68% at one, two and three years, respectively. Patients with early recurrence of AF had less prevalence of sinus rhythm in late follow-up (P < 0.001). Multivariate Cox regression analysis showed that AF duration [hazard ratio (HR) 1.014, 95% CI 1.009-1.020, P < 0.001] and early recurrence of AF (HR 3.45, 95% CI 1.50-7.95, P = 0.004) were independent risk factors for failure. In conclusion, in our series, early recurrence of AF after surgical ablation is a strong predictor of late failure.
authors.affiliation: Department of Cardiac Surgery, Cardiovascular Institute, Hospital Clínico San Carlos, 28040 Madrid, Spain. lcmarotoc@hotmail.com
authors.forename: Luis C
authors.initials: LC
authors.lastname: Maroto
authors.forename: Manuel
authors.initials: M
authors.lastname: Carnero
authors.forename: Jacobo A
authors.initials: JA
authors.lastname: Silva
authors.forename: Javier
authors.initials: J
authors.lastname: Cobiella
authors.forename: Nicasio
authors.initials: N
authors.lastname: Pérez-Castellano
authors.forename: Fernando
authors.initials: F
authors.lastname: Reguillo
authors.forename: Julián
authors.initials: J
authors.lastname: Pérez-Villacastín
authors.forename: José E
authors.initials: JE
authors.lastname: Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013997:Time Factors; D017211:Treatment Failure