PMID- 28262298
OWN - NLM
STAT- MEDLINE
DCOM- 20170905
LR  - 20170906
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 104
IP  - 2
DP  - 2017 Aug
TI  - Should We Ablate Atrial Fibrillation During Coronary Artery Bypass Grafting and 
      Aortic Valve Replacement?
PG  - 515-522
LID - S0003-4975(16)31822-7 [pii]
LID - 10.1016/j.athoracsur.2016.11.081 [doi]
AB  - BACKGROUND: This study evaluates the safety and efficacy of concomitant atrial 
      fibrillation (AF) ablation in patients with AF undergoing coronary artery bypass 
      grafting (CABG) or aortic valve replacement (AVR) or both. METHODS: This is a 
      single-center retrospective study of patients with AF presenting for CABG or AVR 
      or both between 2009 and 2013. They were divided into an ablation group that 
      underwent concomitant AF ablation and a control group that did not. Follow-up 
      data were obtained using telephone interviews. The data were 100% complete with a 
      median follow-up of 30 months. RESULTS: A total of 375 patients with AF presented 
      for CABG (44%), AVR (27%), or CABG and AVR (29%). The ablation (129 patients) and 
      control (246 patients) groups had similar baseline characteristics. The ablation 
      group had significantly longer cardiopulmonary bypass and cross-clamp times, 
      adding a mean of 31 +/- 3 and 22 +/- 3 minutes (p < 0.01 for both), respectively. 
      There were similar unadjusted rates of hospital mortality (4.7% versus 5.3%, p = 
      0.79), stroke (3.1% versus 3.3%, p = 0.94), and reopening (4.7% versus 6.5%, p = 
      0.46) between the groups. The intensive care and hospital length of stays were 
      similar. The ablation group had a lower incidence of postoperative AF (27% versus 
      78%, p < 0.01). Adjusted operative mortality was similar, but the intervention 
      group had significantly lower odds of postoperative AF (odds ratio 0.11, p < 
      0.01). Although there was no difference in mid-term survival, the ablation group 
      had higher mid-term AF-free survival (p < 0.01) and a trend toward higher 
      anticoagulation-free (p = 0.09) and stroke-free survival (p = 0.08). CONCLUSIONS: 
      Concomitant AF ablation in patients with AF undergoing CABG or AVR or both does 
      not increase perioperative rates of mortality or morbidity. Moreover, concomitant 
      AF ablation is effective at reducing postoperative AF burden and increases 
      mid-term AF-free survival.
CI  - Copyright (c) 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Al-Atassi, Talal
AU  - Al-Atassi T
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Kimmaliardjuk, Donna-May
AU  - Kimmaliardjuk DM
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Dagenais, Camille
AU  - Dagenais C
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Bourke, Michael
AU  - Bourke M
AD  - Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Lam, Buu-Khanh
AU  - Lam BK
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Rubens, Fraser D
AU  - Rubens FD
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada. Electronic address: frubens@ottawaheart.ca.
LA  - eng
PT  - Journal Article
DEP - 20170303
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/complications/*surgery
MH  - Catheter Ablation/*methods
MH  - *Coronary Artery Bypass
MH  - Coronary Artery Disease/complications/*surgery
MH  - *Decision Making
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/complications/*surgery
MH  - *Heart Valve Prosthesis Implantation
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Odds Ratio
MH  - Ontario/epidemiology
MH  - Postoperative Complications/epidemiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2017/03/07 06:00
MHDA- 2017/09/07 06:00
CRDT- 2017/03/07 06:00
PHST- 2016/11/12 00:00 [received]
PHST- 2016/11/29 00:00 [accepted]
PHST- 2017/03/07 06:00 [pubmed]
PHST- 2017/09/07 06:00 [medline]
PHST- 2017/03/07 06:00 [entrez]
AID - S0003-4975(16)31822-7 [pii]
AID - 10.1016/j.athoracsur.2016.11.081 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2017 Aug;104(2):515-522. doi: 10.1016/j.athoracsur.2016.11.081. 
      Epub 2017 Mar 3.