Key result
Concomitant AF ablation during bioprosthetic valve replacement yields ~60% five-year freedom from AF recurrence.
Why the study?
Scarce data have been reported on the efficacy of concomitant atrial fibrillation ablation in patients undergoing bioprosthetic valve replacement.
Does concomitant atrial fibrillation ablation improve long-term rhythm and valve-related outcomes in patients undergoing bioprosthetic valve replacement?
Cohort (n=146)
Does concomitant atrial fibrillation ablation improve long-term rhythm and valve-related outcomes in patients undergoing bioprosthetic valve replacement?
Concomitant AF ablation during bioprosthetic valve replacement yields satisfactory long-term clinical outcomes, though AF recurrence is frequent, particularly in older patients with prior cardiac surgery or large left atria.
Acceptable survival with frequent AF recurrence in elderly bioprosthetic valve patients; leaves open optimal selection and randomized confirmation of rhythm benefit.
BACKGROUND: Scarce data have been reported on the efficacy of concomitant atrial fibrillation (AF) ablation in patients undergoing bioprosthetic valve replacement. METHODS: From 2001 and 2014, 146 consecutive patients (69.3±9.4 years, 84 females) who underwent bioprosthetic heart valve replacement concomitant with AF ablation were assessed. We evaluated long-term rhythm and valve-related outcomes. RESULTS: During 49.1 months of follow-up (interquartile range, 22.5-96.8 months), 7 in-hospital and 49 (6.7% per person-year) post-discharge deaths occurred. The thromboembolic event-free survival rate at 5 years was 79.2%±3.5%. The freedom from AF recurrence rate at 5 years was 59.8%±4.9%. Multivariate analysis showed that old age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02-1.11; p=0.002), previous cardiac operation (HR, 3.01; 95% CI, 1.22-7.43; p=0.02), and a large left atrial (LA) dimension (HR, 1.02; 95% CI, 1.00-1.05; p=0.045) were significantly associated with AF recurrence. CONCLUSION: The overall long-term clinical outcomes in these predominantly elderly patients undergoing AF ablation concomitantly with bioprosthetic valve replacement were satisfactory; however, AF recurrence was frequent. Older age, a history of prior cardiac surgery, and large LA size were associated with an increased risk of AF recurrence.
No takes yet. Share an insight, caveat, or question.
Pyo et al. (2019) conducted a cohort in Atrial fibrillation in patients undergoing bioprosthetic valve replacement (n=146). Concomitant atrial fibrillation ablation was evaluated on Freedom from AF recurrence at 5 years. Concomitant atrial fibrillation ablation during bioprosthetic valve replacement yielded a 5-year freedom from AF recurrence rate of 59.8%, with older age and prior surgery predicting recurrence.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: