Long-Term Outcome Following Concomitant Surgical Ablation for Atrial Fibrillation at University Hospital Basel: A Retrospective Study

Background and Objectives: This study aims to examine the success of concomitant surgical ablation in patients with atrial fibrillation after one, three, and five years. Additionally, important predictors for rhythm outcome and rates of permanent pacemaker implantations were analyzed. Materials and...

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Published in:Medicina (Kaunas, Lithuania) Vol. 61; no. 1; p. 41
Main Authors: Hersperger, Elodie, Schaerli, Nicolas, Gahl, Brigitta, Reuthebuch, Oliver, Eckstein, Friedrich S., Winkler, Bernhard, Grapow, Martin T. R.
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 01.01.2025
MDPI
Subjects:
Ablation
Ablation (Surgery)
Aged
Analysis
Antiarrhythmics
Atrial fibrillation
Atrial Fibrillation - surgery
Cardiac arrhythmia
cardiac surgery
Cardioversion
Catheter Ablation - methods
Catheter Ablation - statistics & numerical data
Catheters
Electrocardiography
Female
Follow-Up Studies
Heart
Heart beat
Heart surgery
Hospitals
Hospitals, University - organization & administration
Hospitals, University - statistics & numerical data
Humans
Male
Medical research
Medicine, Experimental
Middle Aged
Mortality
Pacemaker, Artificial - statistics & numerical data
Pacemakers
Patients
Retrospective Studies
Success
surgical ablation
Switzerland
Thoracic surgery
Time Factors
Treatment Outcome
Variables
Switzerland
cardiac surgery
atrial fibrillation
surgical ablation
ISSN:1648-9144, 1010-660X, 1648-9144
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Summary:Background and Objectives: This study aims to examine the success of concomitant surgical ablation in patients with atrial fibrillation after one, three, and five years. Additionally, important predictors for rhythm outcome and rates of permanent pacemaker implantations were analyzed. Materials and Methods: In this retrospective study, we included patients who were referred to the University Hospital of Basel, Switzerland, between 2011 and 2017. Primary outcome was one-year success of surgical ablation. Secondary outcomes include heart rhythm during entire follow-up, three- and five-years success, and need for additional arrhythmia interventions (incl. pacemaker implantation). Results: A total of 120 patients were analyzed and divided into two groups: pulmonary vein isolation (n = 55) and left atrial (n = 65). The median follow-up time was 4.4 years. Sinus rhythm was present in 66%, 64%, and 67% after one, three, and five years, respectively. When adjusted for preoperative type of atrial fibrillation, left atrial lesion set increased the chance of achieving sinus rhythm within 5 years by factor 6.5. The pacemaker-implantation rate was 22%, with significantly more pacemaker implantations in the left atrial group (9% vs. 32%, p = 0.0043). Conclusions: These real-world data demonstrate the high success rate of concomitant surgical ablation for atrial fibrillation. Our study highlights the importance of preoperative discussion in an interdisciplinary heart team to weigh the effectiveness of surgical ablation against the risk of a pacemaker implantation.
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These authors contributed equally to this work.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina61010041