Early and Late Results of Permanent Atrial Fibrillation Ablation Surgery in Aortic Valve and CABG Patients

Abstract

Objective: The study investigates the early and late results of permanent atrial fibrillation (AF) ablation surgery concomitant to coronary artery bypass grafting (CABG) and/or aortic valve (AV) surgery. Methods: Between February 2001 and April 2006, a selective group of 80 patients with permanent AF (median: 48 months [Perc_25/75 24/110; range: 6 – 360 months]) underwent either bipolar (n = 60) or monopolar (n = 20) radiofrequency (RF) ablation procedures concomitant to CABG and/or AV surgery (CABG: n = 39; AV: n = 30; AV + CABG: n = 11). All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class early (3 ± 1 months) and late after surgery (30 ± 15 months). Data were analyzed exploratively. Results: Survival at 3 and 30 months was 98 % and 96 %, respectively. Stable SR could be documented in 73 % and 77 % of patients. Long-term AF before surgery and larger LA size were predictive for AF return after surgery (p = 0.004 and p = 0.032, respectively). Neither age, gender, the application modus of the RF energy nor the underlying cardiac disease influenced the postoperative cardiac rhythm significantly. NYHA class improved significantly after surgery (p < 0.0005), particularly when stable SR was achieved (p = 0.049). Conclusion: Preoperative permanent AF duration time and larger LA size are useful variables to predict the success rate of concomitant ablation surgery in CABG and/or AV patients. Further it could be demonstrated that established SR remained stable over time.

Key words

aortic valve surgery - arrhythmia surgery - atrial fibrillation - coronary artery bypass grafting - radiofrequency ablation

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