PMID- 18481234
OWN - NLM
STAT- MEDLINE
DCOM- 20081008
LR  - 20080515
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 56
IP  - 4
DP  - 2008 Jun
TI  - Ablation surgery failure after combined permanent atrial fibrillation ablation 
      and mitral valve surgery.
PG  - 185-9
LID - 10.1055/s-2008-1038373 [doi]
AB  - OBJECTIVE: The aim of this study was to evaluate the early and late results of a 
      permanent atrial fibrillation (pAF) ablation concept carried out concomitantly 
      with mitral valve (MV) surgery and to identify risk factors for ablation surgery 
      failure. METHODS: Between February 2001 and April 2006, 109 patients with pAF 
      over a median time of 48 months (Perc25/75; range 6 - 396 months) underwent 
      monopolar endocardial radiofrequency ablation procedures concomitantly with MV 
      surgery. 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 (36 +/- 19 months). For data assessment an 
      explorative data analysis including univariate and multivariate binary logistic 
      regression was performed. RESULTS: Early and late survival was 95 % and 91 %, 
      respectively; at follow-up stable SR was documented in 76 % (74 %) of patients. 
      NYHA class improved significantly after surgery ( P = 0.009), particularly when 
      stable SR was achieved ( P = 0.042). Among these MV patients left atrial (LA) 
      enlargement and pAF of long-time duration prior to surgery were detected as risk 
      factors for postoperative recurrence and persistence of atrial fibrillation ( P = 
      0.026 and P = 0.002); furthermore, advanced age and significant tricuspidal 
      regurgitation at the time of surgery were also relevant. The best prediction (95 
      % of patients) for SR, as demonstrated in a multivariate model, was based on the 
      factors LA size and pAF duration ( P = 0.052 and 0.005). CONCLUSION: Particularly 
      the preoperative LA size and pAF duration seem to be useful parameters to 
      evaluate the success rate of ablation performed concomitantly with MV surgery. It 
      could be demonstrated that an established SR remains stable over time.
FAU - Geidel, S
AU  - Geidel S
AD  - Hanseatic Heart Center, Department of Cardiac Surgery, Asklepios Hospital St. 
      Georg, Hamburg, Germany. s.geidel@asklepios.com
FAU - Lass, M
AU  - Lass M
FAU - Jensen, F
AU  - Jensen F
FAU - Hassan, K
AU  - Hassan K
FAU - Boczor, S
AU  - Boczor S
FAU - Kuck, K-H
AU  - Kuck KH
FAU - Ostermeyer, J
AU  - Ostermeyer J
FAU - Schneider, C
AU  - Schneider C
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/epidemiology/*surgery
MH  - *Catheter Ablation
MH  - Comorbidity
MH  - Electrocardiography
MH  - Female
MH  - Heart Valve Diseases/epidemiology/*surgery
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*surgery
MH  - Multivariate Analysis
MH  - Treatment Failure
EDAT- 2008/05/16 09:00
MHDA- 2008/10/09 09:00
CRDT- 2008/05/16 09:00
PHST- 2008/05/16 09:00 [pubmed]
PHST- 2008/10/09 09:00 [medline]
PHST- 2008/05/16 09:00 [entrez]
AID - 10.1055/s-2008-1038373 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2008 Jun;56(4):185-9. doi: 10.1055/s-2008-1038373.