ablation therapy for the treatment of atrial fibrillation (AF) can be performed
as a concomitant procedure alongside cardiac surgery, but carries the risks of
increased bypass time and damage to the sinoatrial node. This study aims to assess
the efficacy of concomitant surgical AF ablation and develop a novel scoring
system to predict post-procedural return to sinus rhythm.
Methods: Ablation (n=53) and
control (n=36) groups were retrospectively selected from the Leeds General
Infirmary surgical database. Follow-up was obtained using patient notes, clinic
letters and echocardiographic data. Primary outcome was freedom from AF at
median follow up (ablation group=383 days, control group=317 days). A novel scoring
system was created through analysis of previous literature and evaluated using
a receiver operating characteristic (ROC) curve.
Results: A larger proportion
of the ablation group was free from AF at median follow up when compared to
controls (50.9% vs. 2.8% respectively, p = <0.001). The novel scoring system was shown to predict post-procedural
return to sinus rhythm (ROC AUC = 0.7708).
Conclusion: Addition of a
concomitant ablation procedure significantly increases levels of return to
sinus rhythm in patients undergoing cardiac surgery. A novel scoring system was
shown to adequately predict procedural success. These results can be further
validated using larger patient cohorts.
Credits: Norton A; Schlosshan D; Ahmed I; Tayebjee M