> Details

Suwalski, Piotr; Kowalewski, Mariusz; Jasiński, Marek; Staromłyński, Jakub; Zembala, Marian; Widenka, Kazimierz; Brykczyński, Mirosław; Skiba, Jacek; Zembala, Michał Oskar; Bartuś, Krzysztof; Hirnle, Tomasz; Dziembowska, Inga; Deja, Marek; Tobota, Zdzisław; Maruszewski, Bohdan J

Surgical ablation for atrial fibrillation during isolated coronary artery bypass surgery

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Surgical ablation for atrial fibrillation during isolated coronary artery bypass surgery
  • Contributor: Suwalski, Piotr; Kowalewski, Mariusz; Jasiński, Marek; Staromłyński, Jakub; Zembala, Marian; Widenka, Kazimierz; Brykczyński, Mirosław; Skiba, Jacek; Zembala, Michał Oskar; Bartuś, Krzysztof; Hirnle, Tomasz; Dziembowska, Inga; Deja, Marek; Tobota, Zdzisław; Maruszewski, Bohdan J
  • imprint: Oxford University Press (OUP), 2019
  • Published in: European Journal of Cardio-Thoracic Surgery
  • Language: English
  • DOI: 10.1093/ejcts/ezz298
  • ISSN: 1010-7940; 1873-734X
  • Keywords: Cardiology and Cardiovascular Medicine ; Pulmonary and Respiratory Medicine ; General Medicine ; Surgery
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Our goal was to evaluate early sequelae and long-term survival in patients undergoing isolated coronary artery bypass grafting (CABG) with concomitant surgical ablation for atrial fibrillation (AF).</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Procedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were collected. A total of 7879 patients with underlying AF underwent isolated CABG between 2006 and 2018 in 37 reference centres across Poland. The mean follow-up was 4.7 ± 3.5 years [median (interquartile range) 4.3 (1.7–7.4)]. Propensity score matching and Cox proportional hazards models were used to compare isolated CABG + ablation with isolated CABG.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Of the included patients, 346 (4.39%) underwent surgical ablation. Patients in this group were significantly younger (66.4 ± 7.5 vs 69.2 ± 8.2; P &lt; 0.001) but had a non-significant, different baseline surgical risk (EuroSCORE: 2.11 vs 2.50; P = 0.088). After a rigorous 1:3 propensity matching (LOGIT model: 306 cases of isolated CABG + ablation vs 918 of isolated CABG alone), surgical ablation was associated with a lower 30-day risk of death [risk ratio 0.37, 95% confidence interval (CI) 0.15–0.91; P = 0.032] and multiorgan failure (risk ratio 0.29, 95% CI 0.10–0.94; P = 0.029). In the long term, surgical ablation was associated with a significant 33% improved overall survival rate: hazard ratio 0.67, 95% CI 0.49–0.90; P = 0.008. The benefit of ablation was sustained in the subgroups but was most pronounced in lower risk older patients (age &gt;70 years, P = 0.020; elective status, P = 0.011) with 3-vessel disease (P = 0.036), history of a cerebrovascular accident (P = 0.018) and preserved left ventricular function [left ventricular ejection fraction &gt;50%; P = 0.017; no signs of heart failure (per New York Heart Association functional class); P = 0.001] and those undergoing on-pump CABG (P &lt; 0.001).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSION</jats:title> <jats:p>Surgical ablation for AF in patients undergoing isolated CABG is safe and associated with significantly improved long-term survival.</jats:p> </jats:sec>
  • Access State: Open Access