Contemporary use of surgical radiofrequency ablation and coronary artery bypass in patients with long-standing, persistent atrial fibrillation and coronary heart disease

Abstract

Atrial fibrillation is one of the main types of arrhythmia; it leads to deterioration in haemodynamics, a decrease in patient's quality of life, the development of complications such as stroke, a decrease in tolerance to physical stress and ultimately death. The reported prevalence of atrial fibrillation among the general population is 0.4%-1%. The incidence of atrial fibrillation has been found to increase with age such that every 10-year increase in age doubles the incidence of this disease. The incidence of coronary heart disease also increases with age. Current studies have shown an increase in concomitant diseases such as coronary heart disease and atrial fibrillation; these pose a serious health threat and increase the risk of patient death. The present review discusses surgical methods for treating long-standing, persistent atrial fibrillation in patients with coronary heart disease based on radiofrequency and cryoablation with simultaneous coronary artery bypass grafting. The present review revealed that biatrial ablation allows achieving high levels of markers that indicate atrial fibrillation recurrence-free survival following simultaneous surgical correction of coronary heart disease in the long-term postoperative period; however, patients undergoing this procedure require permanent pacemaker implantation due to the high incidence of irreversible sinus node dysfunction caused by the exposure to additional ablation lines in the right atrium. Published articles were searched from January to July 2019 using PubMed, eLIBRARY, Elsevier and MEDLINE.