Thorac Cardiovasc Surg 2006; 54(2): 91-95
DOI: 10.1055/s-2005-872860
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Permanent Atrial Fibrillation Ablation Surgery in CABG and Aortic Valve Patients is at Least as Effective as in Mitral Valve Disease

S. Geidel1 , J. Ostermeyer1 , M. Laß1 , M. Geisler1 , N. Kotetishvili1 , H. Aslan1 , S. Boczor2 , K.-H. Kuck2
  • 1Abteilung für Herzchirurgie, Allgemeines Krankenhaus St. Georg, Hamburg, Germany
  • 2Abteilung für Kardiologie, Allgemeines Krankenhaus St. Georg, Hamburg, Germany
Presented at the 34th DGTHG Annual Meeting, Hamburg, February 16, 2005
Further Information

Publication History

Received February 21, 2005

Publication Date:
15 March 2006 (online)

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Abstract

Background: Data on combined permanent atrial fibrillation (pAF) surgery and coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) are scarce, and the mid- and long-term effects on survival and cardiac rhythm are unknown. Material and Methods: In a prospective analysis 125 patients (Group I: CABG and/or AVR, n = 50; Group II: mitral valve [MV] surgery, n = 75) with pAF (≥ 6 months) underwent either concomitant monopolar (Group I: n = 20; Group II: n = 75) or bipolar (Group I: n = 30) radiofrequency (RF) ablation procedures. Group I patients had a significantly smaller left atrial (LA) size than Group II patients (LA-diameter: 47.7 ± 4.6 vs. 58.2 ± 6.1 mm; p < 0.01). Regular follow-up was performed from 3 to 36 months after surgery to assess survival, NYHA-class, and conversion rate to stable sinus rhythm (SR). Results: Early mortality (< 30 days) of Group I patients was 0 % (Group II: 2.7 %), cumulative survival at long-term follow-up was 0.95 vs. 0.82 (p = 0.31) and NYHA-class improved significantly in both groups, particularly in cases with stable SR. At follow-up 80 % of Group I patients had SR (Group II: 70 %). In Group I patients the bipolar approach was associated with significantly shorter ablation procedure times compared to the monopolar procedure (12.1 ± 3.4 vs. 18.9 ± 1.6 min; p < 0.05). Conclusions: Concomitant pAF ablation surgery in CABG and/or AVR is safe and at least as effective as in MV surgery, presumably because severe LA enlargement is exceptionally rare in this group.