Key result
Surgical ablation combined with mitral valve surgery significantly increased sinus rhythm restoration at 1 year to 66.0% compared to 25.7% with isolated mitral valve surgery.
Why the study?
Despite Class IA recommendations for surgical ablation during mitral valve surgery, concerns regarding procedural complexity, extended operative time, and postoperative risks have limited its widespread adoption.
Does concomitant surgical ablation improve sinus rhythm restoration in patients with atrial fibrillation undergoing mitral valve surgery compared to isolated mitral valve surgery?
Population
1219 patients undergoing mitral valve repair or replacement across 15 RCTs
Comparison
Concomitant surgical ablation vs isolated mitral valve repair or replacement
Design
Systematic review of randomized controlled trials
Authors
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Supports concomitant ablation with MVR in AF to improve sinus rhythm; confirms prior trial findings on efficacy and safety.
Systematic Review (n=1,219)
Does concomitant surgical ablation improve sinus rhythm restoration in patients with atrial fibrillation undergoing mitral valve surgery compared to isolated mitral valve surgery?
Absolute Event Rate: 66.01% vs 25.73%
Concomitant surgical ablation during mitral valve surgery significantly improves sinus rhythm restoration at 1 year without increasing short-term mortality or stroke risk, though it may slightly increase the need for permanent pacemakers.
Hamodat et al. (2025) conducted a systematic review in Atrial fibrillation in patients undergoing mitral valve surgery (n=1,219). Concomitant surgical ablation vs. Isolated mitral valve surgery was evaluated on Sinus rhythm restoration at 1 year. Surgical ablation combined with mitral valve surgery significantly increased sinus rhythm restoration at 1 year to 66.0% compared to 25.7% with isolated mitral valve surgery.
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