Niv Ad1, Sari D Holmes2. 1. Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia; Cardiovascular Surgery, Washington Adventist Hospital, Takoma Park, Maryland; Inova Fairfax Hospital, Falls Church, Virginia. Electronic address: nivadmd14@gmail.com. 2. Heart and Vascular Institute, West Virginia University Medicine, Morgantown, West Virginia.
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.
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.
Authors: Niv Ad; Ralph J Damiano; Vinay Badhwar; Hugh Calkins; Mark La Meir; Takashi Nitta; Nicolas Doll; Sari D Holmes; Ali A Weinstein; Marc Gillinov Journal: J Thorac Cardiovasc Surg Date: 2017-03-02 Impact factor: 5.209
Authors: Vinay Badhwar; J Scott Rankin; Ralph J Damiano; A Marc Gillinov; Faisal G Bakaeen; James R Edgerton; Jonathan M Philpott; Patrick M McCarthy; Steven F Bolling; Harold G Roberts; Vinod H Thourani; Rakesh M Suri; Richard J Shemin; Scott Firestone; Niv Ad Journal: Ann Thorac Surg Date: 2017-01 Impact factor: 4.330
Authors: Doreen Schreiber; Thomas Rostock; Max Fröhlich; Arian Sultan; Helge Servatius; Boris A Hoffmann; Jakob Lüker; Imke Berner; Benjamin Schäffer; Karl Wegscheider; Susanne Lezius; Stephan Willems; Daniel Steven Journal: Circ Arrhythm Electrophysiol Date: 2015-03-05
Authors: Giacomo Mugnai; Carlo de Asmundis; Burak Hünük; Erwin Ströker; Vedran Velagic; Darragh Moran; Diego Ruggiero; Ebru Hacioglu; Jan Poelaert; Christian Verborgh; Vincent Umbrain; Stefan Beckers; Hugo Enrique Coutino-Moreno; Ken Takarada; Pedro Brugada; Gian-Battista Chierchia Journal: Heart Rhythm Date: 2015-12-24 Impact factor: 6.343
Authors: Jason G Andrade; Laurent Macle; Paul Khairy; Yaariv Khaykin; Roberto Mantovan; Giuseppe De Martino; Jian Chen; Carlos A Morillo; Paul Novak; Peter G Guerra; Girish Nair; Esteban G Torrecilla; Atul Verma Journal: J Cardiovasc Electrophysiol Date: 2012-08-17