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J. Cardiothorac. Vasc. Anesth. · Sep 2024
Surgical Ablation for Atrial Fibrillation: Risk Factors for Recurrence and Long-Term Outcome.
- Jonathan Frogel, Alexander Kogan, John G Augoustides, Tamer Jamal, Nir Shimoni, Roni Postan-Koren, Viktoriia Ivanov, Avi Sabbag, Ehud Raanani, and Leonid Sternik.
- Department of Anesthesiology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- J. Cardiothorac. Vasc. Anesth. 2024 Sep 1; 38 (9): 197219771972-1977.
ObjectivesAtrial fibrillation (AF) is the most common cardiac arrhythmia. Due to the insufficient efficacy of antiarrhythmic drugs and their adverse side effects, there has been considerable interest in the interventional treatment of AF, including both catheter ablation and surgical ablation. Surgical ablation or the maze procedure is a treatment option for patients with AF undergoing concomitant or isolated cardiac surgery.DesignWe performed a retrospective study of prospectively collected data to investigate short- and long-term outcomes of patients who underwent the surgical ablation of AF. Outcome variables included freedom from recurrent atrial arrhythmias and mortality at 1-, 3-, 5-, and 7-year follow-ups. We also identified risk factors for arrhythmia recurrence and mortality.SettingIsrael's largest university tertiary care center.ParticipantsThe study population comprised 668 patients operated on between January 1, 2006, and June 30, 2022. All patient data were extracted from our departmental database.InterventionsConcomitant or stand-alone surgical AF ablation.Measurements And Main ResultsThe mean duration of follow-up was 106 ± 66.7 months. Freedom from AF was 97.6% (n = 615) and mortality was 3% (n = 20) at the 1-year follow-up, 95.3% (n = 574) and 6.1% (n = 45) at 3 years, 90.1% (n = 396) and 9.1% (n = 61) at 5 years, and 77.5% (n = 308) and 10.8% (n = 72) at 7 years. According to logistic regression analysis, age and female sex determined the 7-year freedom from AF, and risk factors for 7-year mortality included diabetes mellitus, age, and valve surgery.ConclusionsSurgical ablation had a high success rate, with freedom from recurrent atrial arrhythmia at 1-, 3-, 5-, and 7-year follow-ups. Age and female sex were factors determining the 5- and 7-year recurrence of AF.Copyright © 2024 Elsevier Inc. All rights reserved.
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