Key result
Advanced age ≥70 years (33% vs 19%), AF duration ≥5 years (41% vs 12%), and left atrial size >55mm (31% vs 16%) were associated with higher rates of persistent AF after ablation (P<0.05 for all).
Cohort (n=104)
p-value: p=<0.05
Advanced age, prolonged AF duration, and severe left atrial enlargement are significant risk factors for failure of concomitant AF ablation during mitral valve surgery.
May inform risk stratification before concomitant ablation; leaves open whether tailored strategies improve outcomes in these patients.
Objective: It was the aim of this study to evaluate late results of permanent atrial fibrillation (AF) ablation concomitant to mitral valve (MV) surgery. Methods: 104 patients with permanent AF for 0.5–33 years underwent monopolar radiofrequency ablation procedures concomitant to MV surgery. All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class late after surgery (34±19 months). Results: Late survival was 92% (96 of 104 patiens; total deaths: n=8). Advanced age, AF long-time duration and enlargement of the left atrium (LA) at time of surgery were detected to be incremental risk factors for postoperative recurrence and persistence of AF (Table). AF at follow-up SR at follow-up P-value 1.1. Age <70 years (n=52) 19% 81% 1.1. vs. 1.2.: 1.2. Age ≥70 years (n=44) 33% 67% <0.05 2.1. AF duration <5 years (n=52) 12% 88% 2.1. vs. 2.2.: 2.2. AF duration ≥5 years (n=44) 41% 59% <0.05 3.1. LA size ≤55mm (n=38) 16% 84% 3.1. vs. 3.2.: 3.2. LA size >55mm (n=58) 31% 69% <0.05 Total (n=96) 25% 75% - NYHA class improved significantly after surgery, particularly when stable SR was achieved (from 3.0±0.2 to 1.3±0.5, p<0.01). Conclusion: (1) The data allow to calculate the risk of permanent AF ablation surgery failure in MV patients and (2) demonstrate that established SR improves functional class late after surgery.
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Geidel et al. (2007) conducted a cohort in Permanent atrial fibrillation (n=104). Advanced age (≥70 years), AF duration ≥5 years, and LA size >55mm vs. Age <70 years, AF duration <5 years, and LA size ≤55mm was evaluated on Postoperative recurrence and persistence of AF (p=<0.05). Advanced age ≥70 years (33% vs 19%), AF duration ≥5 years (41% vs 12%), and left atrial size >55mm (31% vs 16%) were associated with higher rates of persistent AF after ablation (P<0.05 for all).
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