Key result
A review of the challenges in treating concomitant atrial fibrillation during non-mitral valve surgery proposes a total epicardial lesion set without incisions as a potential solution.
A total epicardial lesion set without atriotomies is proposed to encourage wider adoption of concomitant surgical ablation for atrial fibrillation during non-mitral valve cardiac surgery.
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May encourage concomitant AF ablation in non-mitral surgery; hypothesis-generating pending prospective validation of epicardial sets.
Treatment of atrial fibrillation (AF) in concomitant surgery is not unanimously agreed upon in the cardiac surgical community. The reason for this lack of consensus is threefold. Firstly, there is an absence of large multicenter randomized controlled trials (RCT) proving the benefit of restoring sinus rhythm in a patient population which we encounter almost daily (about 10% of cardiac surgery patients are diagnosed with AF). Secondly, for patients undergoing cardiac surgery without the need for an atriotomy, the Maze procedure is not widely accepted. In these patients, many surgeons do not think that the increased complexity outweighs the potential future benefits of sinus rhythm. Thirdly, due to our limited understanding of this pathology, we are confronted with many choices of ablation tools and lesion sets. In this perspective these issues are reviewed. As a possible solution, a total epicardial lesion set without any incisions is proposed.
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Meir et al. (2014) conducted a review in Atrial fibrillation in non-mitral valve surgery. Total epicardial lesion set without incisions was evaluated. A review of the challenges in treating concomitant atrial fibrillation during non-mitral valve surgery proposes a total epicardial lesion set without incisions as a potential solution.
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