title: Quality of Life after Surgical Ablation of Persistent Atrial Fibrillation: A Prospective Evaluation.
abstract: OBJECTIVE
  To compare the quality of life (QoL) of patients with persistent atrial fibrillation (AF) and ischaemic heart disease after modified mini-maze (MM) procedure or pulmonary vein isolation (PVI) using radiofrequency ablation (RFA) with patients in the control group (coronary artery bypass graft [CABG]) alone.
  
  
  METHODS
  In this prospective randomised study, we included 95 patients with persistent AF and coronary heart disease who underwent open-heart surgery combined with intraoperative irrigated RFA (irrRFA). Patients were randomly assigned to three groups: CABG and PVI using irrRA (CABG+PVI, n=31), CABG and MM procedure using irrRA (CABG+MM, n=30), and isolated CABG (CABG alone, n=34). All patients received implantable loop recorders (ILRs). Patient QoL was assessed using the Short Form 36 (SF-36) preoperatively, and one and two years post-operatively. The study primary end point was freedom from AF one year after operation, measured by implantable loop recorders (ILRs); secondary endpoint included long-term clinical outcomes.
  
  
  RESULTS
  No reoperations or hospital mortalities were recorded. Mean follow-up was 14.4±9.7 months. The percentages of patients free from AF determined by ILR were 80%, 86.2%, and 44.1% in the CABG+PVI, CABG+MM, and in the CABG alone groups, respectively. The QoL significantly improved in CABG+PVI and CABG+MM groups compared with CABG alone group in most domains.
  
  
  CONCLUSIONS
  Effective elimination of AF during CABG surgery improves QoL in all physical health domains of the SF-36 and the role-emotional functioning domain. Thus, patients with concomitant AF and coronary heart disease may benefit from intraoperative radiofrequency ablation to prevent relapse of the arrhythmia.
authors.affiliation: Department of Surgery, Aorta, Coronary and Peripheral Arteries, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Chernyavskiy
authors.affiliation: Department of Surgery, Aorta, Coronary and Peripheral Arteries, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia. Electronic address: julia11108@mail.ru.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Kareva
authors.affiliation: Department of Surgery, Aorta, Coronary and Peripheral Arteries, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Inessa
authors.initials: I
authors.lastname: Pak
authors.affiliation: Department of Surgery, Aorta, Coronary and Peripheral Arteries, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Sardor
authors.initials: S
authors.lastname: Rakhmonov
authors.affiliation: Department of Rhythm Disorders of the Heart, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Evgeny
authors.initials: E
authors.lastname: Pokushalov
authors.affiliation: Department of Rhythm Disorders of the Heart, Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Romanov
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life
keywords: Atrial fibrillation; Implantable loop recorders.; Intraoperative radiofrequency ablation; Quality of life