Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8679151 | Seminars in Thoracic and Cardiovascular Surgery | 2017 | 5 Pages |
Abstract
According to guidelines, atrial fibrillation (AF) ablation success should be measured by 24-hour Holter electrocardiogram (ECG). However, information on long-term success, especially obtained by 24-hour Holter ECG, is rare. We therefore analyzed rhythm course and long-term outcomes of our patients undergoing concomitant surgical AF ablation. Between January 2003 and April 2011, 486 patients underwent concomitant surgical AF ablation in our institution. Patients with 24-hour Holter ECG rhythm status available between 5 and 10 years postoperatively were included in this retrospective data analysis (nâ=â155). Ablation lesions were limited to either a pulmonary vein isolation (nâ=â31, 20%), a more complex left atrial lesion set (nâ=â89, 57%), or biatrial lesions (nâ=â35, 23%). Primary end point of the study was freedom from AF during long-term follow-up. Mean patient age was 68.1â±â8.4 years; 57.4% were male. Mean follow-up time was 5.9 years. Surgical AF ablation provided freedom from AF rate of 56.6% during long-term follow-up, with significantly better results in patients with paroxysmal than in those with persistent AF (67.2% vs 51.8% Pâ=â0.03). A stable rhythm course was observed during follow-up, without statistically significant differences between 12 months and latest follow-up (63.2% vs 56.6%; Pâ=â0.25). In multivariate analysis, preoperative paroxysmal AF, duration of AF, and left atrial diameter were predictors of long-term ablation success. Surgical AF ablation provided freedom from AF rate of 56.6% during long-term follow-up. Statistically significant predictors of ablation success at latest follow-up were preoperative paroxysmal AF, duration of AF, and a preoperative smaller left atrial diameter.
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Authors
Simon MD, Susanne MSc, Samer MD, Stephan MD, Hermann MD, PhD, Florian Mathias MD,