Intraoperative ablation during CABG (pulmonary vein isolation or modified mini-maze) increased freedom from atrial fibrillation to 80% and 86.2%, respectively, compared to 44.1% with CABG alone.
RCT (n=95)
Randomized
Does intraoperative irrigated radiofrequency ablation (PVI or modified mini-maze) improve freedom from atrial fibrillation in patients with persistent atrial fibrillation undergoing CABG?
Concomitant intraoperative radiofrequency ablation (PVI or modified mini-maze) during CABG substantially improves freedom from atrial fibrillation compared to CABG alone in patients with persistent AF.
Absolute Event Rate: 86.2% vs 44.1%
OBJECTIVES: We report our experience with a modified mini-maze procedure and pulmonary vein isolation using radiofrequency energy for treating persistent atrial fibrillation during coronary artery bypass grafting (CABG). METHODS: Ninety-five patients with persistent atrial fibrillation and coronary heart disease underwent open heart surgery combined with intraoperative irrigated radiofrequency ablation. Patients were randomized into the following three groups: CABG and irrigated radiofrequency pulmonary vein isolation (CABG+PVI, n = 31); CABG and an irrigated radiofrequency modified mini-maze procedure (CABG+MM, n = 30); and isolated CABG (CABG alone, n = 34). All patients received implantable loop recorders. RESULTS: No reoperation and no hospital mortality were recorded. Mean follow-up was 14.4 ± 9.7 months. The implantable loop recorder-determined freedom from atrial fibrillation was 80% in the CABG+PVI group, 86.2% in the CABG+MM group and 44.1% in the CABG alone group. CONCLUSIONS: Patients with concomitant atrial fibrillation and coronary heart disease may benefit from intraoperative ablation to prevent relapse of arrhythmia.
Cherniavsky et al. (Wed,) conducted a rct in Persistent atrial fibrillation and coronary heart disease (n=95). Intraoperative irrigated radiofrequency ablation (pulmonary vein isolation or modified mini-maze) vs. Isolated CABG was evaluated on Freedom from atrial fibrillation determined by implantable loop recorder. Intraoperative ablation during CABG (pulmonary vein isolation or modified mini-maze) increased freedom from atrial fibrillation to 80% and 86.2%, respectively, compared to 44.1% with CABG alone.