Key result
Biatrial ablation during coronary artery bypass grafting achieves high atrial fibrillation recurrence-free survival but carries a high risk of sinus node dysfunction requiring pacemaker implantation.
Why the study?
Concomitant coronary heart disease and atrial fibrillation pose a serious health threat and increase the risk of death, prompting a review of surgical treatment methods.
Does biatrial ablation with simultaneous CABG improve atrial fibrillation recurrence-free survival in patients with long-standing persistent AF and coronary heart disease?
Does biatrial ablation with simultaneous CABG improve atrial fibrillation recurrence-free survival in patients with long-standing persistent AF and coronary heart disease?
Biatrial ablation during CABG effectively maintains sinus rhythm in patients with long-standing persistent AF but significantly increases the need for permanent pacemaker implantation.
May sustain sinus rhythm in persistent AF with biatrial ablation plus CABG yet raises pacemaker risk; leaves open optimal strategy pending randomized trials.
Atrial fibrillation is one of the main types of arrhythmia; it leads to deterioration in haemodynamics, a decrease in patient’s quality of life, the development of complications such as stroke, a decrease in tolerance to physical stress and ultimately death. The reported prevalence of atrial fibrillation among the general population is 0.4%–1%. The incidence of atrial fibrillation has been found to increase with age such that every 10-year increase in age doubles the incidence of this disease. The incidence of coronary heart disease also increases with age. Current studies have shown an increase in concomitant diseases such as coronary heart disease and atrial fibrillation; these pose a serious health threat and increase the risk of patient death. The present review discusses surgical methods for treating long-standing, persistent atrial fibrillation in patients with coronary heart disease based on radiofrequency and cryoablation with simultaneous coronary artery bypass grafting. The present review revealed that biatrial ablation allows achieving high levels of markers that indicate atrial fibrillation recurrence-free survival following simultaneous surgical correction of coronary heart disease in the long-term postoperative period; however, patients undergoing this procedure require permanent pacemaker implantation due to the high incidence of irreversible sinus node dysfunction caused by the exposure to additional ablation lines in the right atrium. Published articles were searched from January to July 2019 using PubMed, eLIBRARY, Elsevier and MEDLINE. Received 9 July 2019. Revised 22 November 2019. Accepted 26 November 2019. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Author contributions Conception and study design: A.T. KalybekovaDrafting the article: A.T. Kalybekova, A.A. AlmazovCritical revision of the article: A.T. Kalybekova, S.S. RahmonovFinal approval of the version to be published: A.T. Kalybekova, S.S. Rahmonov, A.M. Chernyavskiy, A.A. Almazov, G.P. Narcissova, S.P. Mironenko
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Kalybekova et al. (2019) conducted a review in Long-standing, persistent atrial fibrillation and coronary heart disease. Surgical radiofrequency and cryoablation with simultaneous coronary artery bypass grafting was evaluated. Biatrial ablation during coronary artery bypass grafting achieves high atrial fibrillation recurrence-free survival but carries a high risk of sinus node dysfunction requiring pacemaker implantation.
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