Key result
Minimally invasive AF surgery maintains drug-free sinus rhythm in ~59% of patients at two years.
Why the study?
Trials to maintain sinus rhythm in patients with AF and refractory symptoms have been complicated by lack of success or intolerance of medications, and experience with minimally invasive AF surgery is relatively new with heterogeneous populations and short follow-up periods.
Does minimally invasive surgical ablation maintain sinus rhythm off antiarrhythmic drugs in patients with atrial fibrillation?
Observational (n=33)
No
Does minimally invasive surgical ablation maintain sinus rhythm off antiarrhythmic drugs in patients with atrial fibrillation?
Minimally invasive surgical ablation for AF demonstrates suboptimal long-term efficacy, maintaining sinus rhythm off antiarrhythmic drugs in only 58.6% of patients at nearly two years, with lower success rates in those with persistent AF.
Retrospective single-center data on minimally invasive AF surgery; leaves open questions on long-term efficacy and generalizability.
BACKGROUND: Trials to maintain sinus rhythm in patients with atrial fibrillation (AF) and refractory symptoms have been complicated by lack of success or intolerance of medications. Experience with minimally invasive AF surgery is relatively new, and early results have been promising. However, the study populations and techniques were heterogeneous, and the follow-up periods were short in many series. METHODS: We present a single center experience through a retrospective review of medical records of patients who had minimally invasive AF surgery. RESULTS: The surgical techniques addressed several possible mechanisms of AF and causes of recurrence, including pulmonary vein isolation, underlying substrates modification, ligament of Marshall interruption, ganglion plexus ablation, and left atrial appendage exclusion. Thirty-three cases were identified. The mean duration of follow-up was 23.2 months, and 58.6% were maintained in a sinus rhythm and were off antiarrhythmic drugs at the end of the follow-up period. Cases with persistent AF had a lower success rate. CONCLUSION: Results with minimally invasive surgery are suboptimal at two years of follow-up, particularly for patients with persistent AF.
No takes yet. Share an insight, caveat, or question.
Abo‐Salem et al. (2013) conducted an observational in Atrial fibrillation (n=33). Minimally invasive atrial fibrillation surgery was evaluated on Maintenance of sinus rhythm off antiarrhythmic drugs. Minimally invasive atrial fibrillation surgery maintained sinus rhythm off antiarrhythmic drugs in 58.6% of patients at a mean follow-up of 23.2 months.
Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context: