Key result
Left-atrial ablation was associated with a comparable risk of atrial fibrillation recurrence at 5 years compared to bi-atrial ablation (37.1% vs 30.1%, HR 1.24).
Why the study?
The lesion sets for surgical ablation of atrial fibrillation that provide optimal outcomes have remained controversial.
Does left-atrial surgical ablation compared to bi-atrial surgical ablation improve clinical and rhythm outcomes in patients with atrial fibrillation undergoing concomitant cardiac surgery?
Cohort (n=1,965)
No
Does left-atrial surgical ablation compared to bi-atrial surgical ablation improve clinical and rhythm outcomes in patients with atrial fibrillation undergoing concomitant cardiac surgery?
Hazard Ratio: 1.24 (95% CI 0.96–1.61)
Absolute Event Rate: 37.1% vs 30.1%
p-value: p=0.100
May support left-atrial ablation to simplify concomitant surgery; leaves open randomized confirmation of long-term equivalence.
Background: The lesion sets for surgical ablation of atrial fibrillation (AF) that provide optimal outcomes have remained controversial. Objectives: We evaluated the effects of left-atrial (LA) ablation of AF compared with bi-atrial (BA) ablation on the clinical and rhythm outcomes, and examined the predictors for AF recurrence and permanent pacing in consideration of ablation lesion sets. Methods: Between 2001 and 2018, 1,965 patients underwent surgical ablation during cardiac surgery at our institution. Among these, 796 and 1,169 patients underwent LA and BA ablation, respectively. The clinical outcomes were evaluated after propensity score adjustment, with death accounting for a competing event. The probability of AF recurrence was estimated with the generalized estimating equations model. Results: = 0.091) was comparable between the 2 groups. Conclusions: The risk of AF recurrence and adverse events was comparable between the 2 ablation lesion sets. BA ablation was not related to an increased risk of permanent pacing.
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Kim et al. (2021) conducted a cohort in Atrial Fibrillation (n=1,965). Left-atrial (LA) ablation vs. Bi-atrial (BA) ablation was evaluated on Probability of atrial fibrillation recurrence (HR 1.24, 95% CI 0.96-1.61, p=0.100). Left-atrial ablation was associated with a comparable risk of atrial fibrillation recurrence at 5 years compared to bi-atrial ablation (37.1% vs 30.1%, HR 1.24).
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