Document Type

Article

Publication Date

5-1-2018

College/Unit

School of Medicine

Department/Program/Center

Cardiovascular and Thoracic Surgery

Abstract

Background—An important challenge in surgical ablation for atrial fibrillation (AF) is the scarcity of publications on credible predictors of long-term success in procedures performed with ablation tools that produce consistently reliable transmural lesions. We examined factors associated with 1-year success and no atrial arrhythmia (AA) recurrence during 1 to 5 years after surgical ablation for AF. Methods—The study prospectively monitored 743 surgical ablation patients with complete rhythm follow-up at 12 months after the operation. No detected AA was defined as no known recurrence of AA, no cardioversions, and no catheter ablations at all available follow-up assessments. Results—Patients were a mean age of 64.7 years, and 32% were women. Patients with no detected AA during the first year after surgical ablation were more likely to maintain sinus rhythm without recurrence during 1 to 5 years (74% vs 28%, p < 0.001) and to be in sinus rhythm off medication at 5 years (80% vs 53%, p < 0.001). Mixed-model logistic regression revealed that lower risk for AA recurrence during 1 to 5 years was associated with no detected AA during the first 12 months (odds ratio [OR], 0.11; p < 0.001) and surgeon experience with 50 or more cases (OR, 0.63; p = 0.043), whereas older age (OR, 1.03; p < 0.001) and longer preoperative AF duration (OR, 1.04; p = 0.043) were associated with greater risk for AA recurrence. Conclusions—Most patients with no detected AA throughout the first 12 months after surgical ablation continued to be recurrence free for 5 years. Younger age, shorter preoperative AF duration, and greater surgeon experience may be associated with more persistent surgical correction of AF.

Source Citation

Ad N, Holmes SD. Early Stable Sinus Rhythm Associated With Greater Success 5 Years After Surgical Ablation. The Annals of Thoracic Surgery. 2018;105(5):1370-1376. doi:10.1016/j.athoracsur.2017.11.075

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