Sinus node-atrioventricular node isolation: Long-term results with the “corridor” operation for atrial fibrillation

Abstract OBJECTIVES Previous series showed the outcomes of thoracoscopic ablation of stand-alone symptomatic paroxysmal atrial fibrillation (AF) for up to 7 years of follow-up. The goal of this study was to assess the long-term durability of surgical pulmonary vein isolation (PVI) beyond 7 years. METHODS Fifty consecutive patients {mean age 55 [standard deviation (SD): 11.2] years, previous catheter ablation in 56%, left ventricular ejection fraction 60% (SD: 4.6), left atrium volume 65 ml (SD: 17)} with stand-alone symptomatic paroxysmal AF underwent PVI through bilateral thoracoscopy ablation between 2005 and 2014. The CHA2DS2-VASc score was ≥2 in 12 patients (24%). RESULTS No hospital deaths occurred. At hospital discharge all patients but 1 (2%) were in sinus rhythm (SR). Follow-up was 100% complete [mean 8.4 years (SD: 2.3), max 15]. The 8-year cumulative incidence function of AF recurrence, with death as a competing risk, on or off class I/III antiarrhythmic drugs (AADs)/electrocardioversion/re-transcatheter ablation (TCA) was 20% (SD: 5; 95% confidence interval: 10, 32); and off class I/III AADs/electrocardioversion/re-TCA was 52% (SD: 7; 95% confidence interval: 0.83, 8.02). At 8 years, the predicted prevalence of patients in SR was 87% and 53% were off class I/III AADs/electrocardioversion/re-TCA. The recurrent arrhythmia was AF in all patients except 2, who had atypical atrial flutter (4%). No predictors of AF recurrence were identified. At the last follow-up, 76% of the patients showed European Heart Rhythm Association class I. No strokes or thromboembolic events were documented and 76% of the subjects were off anticoagulation therapy. CONCLUSIONS Despite a considerable AF recurrence rate, our single-centre, long-term outcome of surgical PVI showed encouraging data, with the majority of patients remaining in SR, although many of them were on antiarrhythmic therapy.

Download Full-text

Acute and Long-Term Safety of Same-Day Pacemaker Implant and Atrioventricular Node Ablation for Management of Atrial Fibrillation

Heart Lung and Circulation ◽

10.1016/j.hlc.2018.06.230 ◽

2018 ◽

Vol 27 ◽

pp. S146

Author(s):

A. Quah ◽

M. Tung ◽

P. Novak ◽

C. Lane ◽

L. Sterns ◽

...

Keyword(s):

Atrial Fibrillation ◽

Atrioventricular Node

Download Full-text

Long-term results after ablation for long-standing atrial fibrillation concomitant to surgery for organic heart disease: Is microwave energy reliable?

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2008.05.041 ◽

2008 ◽

Vol 136 (5) ◽

pp. 1156-1159 ◽

Cited By ~ 10

Author(s):

Calin Vicol ◽

Diana Kellerer ◽

Paraskevi Petrakopoulou ◽

Ingo Kaczmarek ◽

Peter Lamm ◽

...

Keyword(s):

Atrial Fibrillation ◽

Heart Disease ◽

Microwave Energy ◽

Long Term Results ◽

Organic Heart Disease

Download Full-text

Effect of preoperative atrial fibrillation on long-term results after Off Pump Coronary Artery Bypass

Perm Medical Journal ◽

10.17816/pmj3865-15 ◽

2021 ◽

Vol 38 (6) ◽

pp. 5-15

Author(s):

Soslan T. Enginoev ◽

Dmitriy A. Kondratiev ◽

Gasan M. Magomedov ◽

Tamara K. Rashidova ◽

Bakytbek K. Kadyraliev ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery ◽

Sinus Rhythm ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Long Term Results ◽

Off Pump ◽

Group I ◽

Pump Coronary Artery Bypass

Objective. To study the effect of preoperative atrial fibrillation (AF) on the risk of stroke and long-term mortality after Off Pump Coronary Artery Bypass (OPCAB). Materials and methods. A retrospective analysis of the results of OPCAB in 212 patients with coronary artery disease (CAD), who were operated on from May 2009 to November 2013, was carried out. After propensity score matching, patients were divided into 2 groups: Group I 82 patients with sinus rhythm (SR) before surgery, Group II (control) 102 patients with AF before surgery. The average age of the included patients was 61 6.7 years, with 95 % CI: 6062. Fifty-four (29.3 %) patients were over 65 years of age. There were 162 men (88 %) and 22 women (12 %). The median follow-up was 93.5 (66.7102.0) months. Results. The time spent in the clinic was statistically significantly shorter in the SR group than in the AF group (10 (911) and 14 (1116) hours, respectively, p 0.001). There was no statistically significant difference in the number of perioperative myocardial infarctions (in the group with SR it occurred in 1 (1.2 %) patient, in the group with AF 2 (2 %), p = 0.7), strokes (in the group with SR 1 (1.2 %), in the group with AF 3 (2.9 %), p = 0.6), as well as a 30-day mortality (in the group with SR it was 0 %, in the group with AF 3 (2.9 %), p = 0.2). In the long-term postoperative period, there were statistically significantly fewer strokes in the group with SR than in the group with AF (in the group with SR, the 10-year stroke freedom was 88.8 %, and in the group with AF 71.8 %, p = 0.018), and also better long-term survival in the group with sinus rhythm (in the group with SR, the 10-year survival rate was 79 %, in the group with AF 63.9 %, p = 0.016). Conclusions. In the group with preoperative AF, the frequency of distant strokes and deaths is higher than in patients with sinus rhythm.

Download Full-text