title: Active ganglionated plexi is a predictor of atrial fibrillation recurrence after minimally invasive surgical ablation.
abstract: OBJECTIVE
  Ganglionated plexi (GP) ablation has been become an important strategy for treating atrial fibrillation (AF). We hypothesize that active GP is a predictor of AF recurrence after minimally invasive surgical AF ablation.
  
  
  METHODS
  Eighty-nine patients with symptomatic lone AF undergoing minimally invasive surgical pulmonary vein isolation combined with GP testing and ablations were followed for a median of 50 months. Success was defined as freedom from any atrial tachyarrhythmia lasting >30 seconds duration.
  
  
  RESULTS
  The single-procedure success rate is 56.3% for paroxysmal AF, 27.3% for persistent AF, and 25% for long-term persistent AF. A mean of 4.1 active GPs were identified in each patient. There were more active GP on the right side than on the left side (2.8 ± 2.2 vs. 1.4 ± 1.2, p<0.001). The number of active GP independently predicted recurrence of AF at 12 months (hazard ratios [95% CI]: 0.67 [0.48, 0.95]; p=0.022), 24 months (0.71 [0.53, 0.95]; p=0.019), and 60 months (0.69 [0.54, 0.89]; p=0.004). Patients with active GP above 5 were associated with higher long-term success rates in comparison to patients with less active GP (p=0.014). Duration of AF >24 months, early recurrence of AF, and left atrial diameter also predicted long-term recurrences of AF.
  
  
  CONCLUSIONS
  The number of active GP is a predictor of AF recurrence after minimally invasive surgical AF ablation. Patients with more active GP were associated with markedly higher single-procedure success rates.
authors: Department of Cardiac Surgery, Atrial Fibrillation Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors: Shuai
authors: S
authors: Zheng
authors: Yaping
authors: Y
authors: Zeng
authors: Yan
authors: Y
authors: Li
authors: Jie
authors: J
authors: Han
authors: Haibo
authors: H
authors: Zhang
authors: Xu
authors: X
authors: Meng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005725:Ganglia, Autonomic / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000601:surgery; D012008:Recurrence; D013997:Time Factors