title: Systematic review and meta-analysis of surgical ablation for atrial fibrillation during mitral valve surgery.
abstract: BACKGROUND
  Surgical ablation has emerged as an acceptable treatment modality for patients with atrial fibrillation (AF) undertaking concomitant cardiac surgery. However, the efficacy of surgical ablation in patient populations undergoing mitral valve surgery is not well established. The present meta-analysis aims to establish the current randomized evidence on clinical outcomes of surgical ablation versus no ablative treatment in patients with AF undergoing mitral valve surgery.
  
  
  METHODS
  Electronic searches were performed using six databases from their inception to September 2013, identifying all relevant randomized controlled trials (RCTs) comparing surgical ablation versus no ablation in AF patients undergoing mitral valve surgery. Data were extracted and analyzed according to predefined clinical endpoints.
  
  
  RESULTS
  Nine relevant RCTs were identified for inclusion in the present analysis. The number of patients in sinus rhythm (SR) was significantly improved in the surgical ablation group compared to the non-ablation group at discharge. This effect on SR remained at all follow-up periods until >1 year. Results indicated that there was no significant difference between surgical ablation and no ablation in terms of 30-day mortality, all-cause mortality, pacemaker implantation, stroke, thromboembolism, cardiac tamponade, reoperation for bleeding and myocardial infarction.
  
  
  CONCLUSIONS
  Results from the present meta-analysis demonstrate that the addition of surgical ablation for AF leads to a significantly higher rate of sinus rhythm in mitral valve surgical patients, with no increase in the rates of mortality, pacemaker implantation, stroke and thromboembolism. Further research should be directed at correlating different surgical ablation subtypes to cardiac and cerebrovascular events at long-term follow-up.
authors: The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ;
authors: Kevin
authors: K
authors: Phan
authors: The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ;
authors: Ashleigh
authors: A
authors: Xie
authors: The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ;
authors: David H
authors: DH
authors: Tian
authors: The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; ; Golden Jubilee National Hospital, Glasgow, United Kingdom ;
authors: Kasra
authors: K
authors: Shaikhrezai
authors: The Collaborative Research (CORE) Group, Macquarie University, Sydney, Australia ; ; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
authors: Tristan D
authors: TD
authors: Yan
keywords: Maze; Surgical ablation; atrial fibrillation; meta-analysis; mitral valve surgery