title: Radiofrequency ablation of atrial fibrillation during concomitant cardiac surgery.
abstract: OBJECTIVE
  We present the experience of our centre with radiofrequency ablation of atrial fibrillation concomitantly with cardiac surgery Methods: 170 patients underwent atrial fibrillation ablation with uni/bipolar-radiofrequency. They were followed for 3-months and then as appropriate for the cardiac disease. In 2013, patients still alive underwent rhythm monitoring with ECG and 24-hour tape if in sinus rhythm
  
  
  RESULTS
  Mean age was 65 years old and 42% of the patients were male. Paroxysmal AF was rare (7%). Most patients had preserved ejection fraction and dilated left atria (diameter 53.2±7.5 mm). The most common indication for cardiac surgery was valve disease. More than 75% of the patients underwent prophylactic closure of the left atrial appendage. Pulmonary vein isolation was performed in all patients, followed by other left atrial ablation lines. Overall, surgical complications were rare, being the most frequent pacemaker implantation (15%). Median length of stay was 9 days (p25-p75:7-14). At discharge, 69% of the patients were in sinus rhythm, being 90% on anticoagulation and 69% on amiodarone. In-hospital mortality was less than 3% (5 patients), none of them related to the ablation procedure. At 3 months, 50% of the patients were in sinus rhythm, being 92% on anticoagulation and 75% on antiarrhythmic drugs. Direct current cardioversion was successful in 8 of 12 patients. In the multivariate analysis, being in sinus rhythm at discharge was the single independent predictor of maintaining sinus rhythm at 3 months. In 2013 (469 patients-year), 40% of the patients were in sinus rhythm, being 80% on anticoagulation and 45% on antiarrhythmic drugs.
  
  
  CONCLUSIONS
  Concurrent atrial fibrillation ablation with radiofrequency achieves satisfactory and stable recovery of sinu rhythm without adding significant operative risk and post-operative complications.
authors.affiliation: Departmentos de Fisiologia e Cirurgia Cardiotorácica, de Ciências da Informação e da Decisão em Sáude (CIDES), Unidade de Investigação e Desenvolvimento Cardiovascular e Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde (CINTESIS) da Faculdade de Medicina da Universidade do Porto e Departamentos de Cirurgia Cardiotorácica e de Cardiologia do Centro Hospitalar S. João, Porto, Portugal.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Pinho-Gomes
authors.forename: Mário J
authors.initials: MJ
authors.lastname: Amorim
authors.forename: Sílvia M
authors.initials: SM
authors.lastname: Oliveira
authors.forename: Luís
authors.initials: L
authors.lastname: Azevedo
authors.forename: Jorge
authors.initials: J
authors.lastname: Almeida
authors.forename: Vítor
authors.initials: V
authors.lastname: Monteiro
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Maciel
authors.forename: Paulo
authors.initials: P
authors.lastname: Pinho
authors.forename: Adelino F
authors.initials: AF
authors.lastname: Leite-Moreira
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation; D015331:Cohort Studies; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies