Journal Article

A 5-year clinical experience with bipolar radiofrequency ablation for permanent atrial fibrillation concomitant to coronary artery bypass grafting and aortic valve surgery

Stephan Geidel, Michael Lass and Jörg Ostermeyer

in Interactive CardioVascular and Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 7, issue 5, pages 777-780
Published in print October 2008 | ISSN: 1569-9293
Published online October 2008 | e-ISSN: 1569-9285 | DOI: http://dx.doi.org/10.1510/icvts.2008.179622
A 5-year clinical experience with bipolar radiofrequency ablation for permanent atrial fibrillation concomitant to coronary artery bypass grafting and aortic valve surgery

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Abstract

This study analyses the 5-year results of permanent atrial fibrillation (pAF) bipolar radiofrequency (RF) ablation surgery concomitant to coronary artery bypass grafting (CABG) and/or aortic valve (AV) surgery. Eighty-five patients with pAF (0.5–30 years) underwent bipolar RF ablation procedure concomitant to CABG/AV surgery. All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class at 8±1 days and at 3±1 and 32±15 months after surgery. Survival at time of re-examination was 100%, 98% and 96%, respectively (three non-cardiac deaths), SR could be documented in 61%, 74% and 78% of patients. Long-term AF before surgery and larger size of the left atrium (LA) were predictive for postoperative AF return (P=0.005, P=0.03); 88% of patients with small preoperative LA-size (<50 mm) and 85% with pAF-duration time <5 years had stable SR at late follow-up. Cardiac rhythm at three months was predictive for long-term rhythm-prognosis (P<0.0001). NYHA-class improved significantly after surgery (P<0.0005), particularly when SR was achieved (P=0.046). Permanent AF bipolar RF ablation surgery revealed excellent results in AV/CABG patients. It could be demonstrated that established SR remained stable over time. Preoperative pAF-duration time and LA-size are useful variables to predict the success rate of ablation.

Keywords: Aortic valve surgery; Arrhythmia surgery; Atrial fibrillation; Bipolar radiofrequency ablation; Coronary artery bypass grafting; Radiofrequency ablation

Journal Article.  2435 words.  Illustrated.

Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery

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