Journal Article

Surgical Ablation of Atrial Fibrillation during Mitral-Valve Surgery

Couderc, Jean-Philippe, Argenziano, Michael, Acker, Michael A, Bolling, Steven F, Mullen, John C, Puskas, John D, Parides, Michael K, Mack, Michael J, Varghese, Robin, Horvath, Keith A, Geller, Nancy L, Bagiella, Emilia, O'Gara, Patrick T, Rose, Eric A, Taddei-Peters, Wendy C, DeRose, Joseph J, Voisine, Pierre, Ailawadi, Gorav, Ascheim, Deborah D, Gelijns, Annetine C, Michler, Robert E, Miller, Marissa A, Bouchard, Denis, Smith, Peter K, Moquete, Ellen G, Blackstone, Eugene H, Chang, Helena L, Moskowitz, Alan J, Gillinov, A. Marc, Williams, Paula, Gardner, Timothy J

2015

Overview

In this trial, patients with atrial fibrillation undergoing mitral-valve surgery were assigned to surgical ablation of AF or no ablation. At 6 and 12 months, more patients in the ablation group were free from AF, but more patients in that group required permanent pacemakers. Atrial fibrillation, which is associated with reduced survival and increased risk of stroke, is present in 30 to 50% of patients presenting for mitral-valve surgery. 1 , 2 The development of open surgical procedures for the ablation of atrial fibrillation has led to their widespread application during cardiac operations, but their effectiveness and safety have not been rigorously established. It is hypothesized that long-term outcomes can be improved by successful ablation in patients with preexisting persistent or long-standing persistent atrial fibrillation who are undergoing mitral-valve surgery. The Cox maze III operation (sometimes called the “cut-and-sew” maze operation) is a complex surgical procedure . . .

• Publisher: Massachusetts Medical Society
• Subject: Ablation / Aged / Atrial Fibrillation - complications / Atrial Fibrillation - prevention & control / Atrial Fibrillation - surgery / Blood clots / Cardiac arrhythmia / Cardiovascular Diseases - mortality / Catheter Ablation - adverse effects / Catheter Ablation - methods / Catheters / Design / Electrocardiography, Ambulatory / Embolisms / FDA approval / Female / Fibrillation / Heart failure / Heart surgery / Heart Valve Diseases - complications / Heart Valve Diseases - surgery / Heart Valve Prosthesis Implantation / Humans / Kaplan-Meier Estimate / Male / Middle Aged / Mitral Valve - surgery / Postoperative Complications / Quality of Life / Royalties / Secondary Prevention / Stroke / Surgery / Surgical outcomes / Surgical techniques / Veins & arteries