A 5-year clinical experience with bipolar radiofrequency ablation for permanent atrial fibrillation concomitant to coronary artery bypass grafting and aortic valve surgery

Abstract

This study analyses the 5-year results of permanent atrial fibrillation (pAF) bipolar radiofrequency (RF) ablation surgery concomitant to coronary artery bypass grafting (CABG) and/or aortic valve (AV) surgery. Eighty-five patients with pAF (0.5-30 years) underwent bipolar RF ablation procedure concomitant to CABG/AV surgery. All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class at 8±1 days and at 3±1 and 32±15 months after surgery. Survival at time of reexamination was 100%, 98% and 96%, respectively (three non-cardiac deaths), SR could be documented in 61%, 74% and 78% of patients. Long-term AF before surgery and larger size of the left atrium (LA) were predictive for postoperative AF return (P=0.005, P=0.03); 88% of patients with small preoperative LA-size (<50 mm) and 85% with pAF-duration time <5 years had stable SR at late follow-up. Cardiac rhythm at three months was predictive for long-term rhythm-prognosis (P<0.0001). NYHA-class improved significantly after surgery (P<0.0005), particularly when SR was achieved (P=0.046). Permanent AF bipolar RF ablation surgery revealed excellent results in AV/CABG patients. It could be demonstrated that established SR remained stable over time. Preoperative pAF-duration time and LA-size are useful variables to predict the success rate of ablation. © 2008 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.