Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement
10.5090/kjtcs.2019.52.2.61
- Author:
WonKyung PYO
1
;
Sung Jun PARK
;
Wan Kee KIM
;
Ho Jin KIM
;
Joon Bum KIM
;
Sung Ho JUNG
;
Suk Jung JOO
;
Cheol Hyun CHUNG
;
Jae Won LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jwlee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Arrhythmia surgery;
Anticoagulants;
Bioprosthesis;
Atrial fibrillation;
Surgical ablation
- MeSH:
Aged;
Anticoagulants;
Atrial Fibrillation;
Bioprosthesis;
Disease-Free Survival;
Follow-Up Studies;
Freedom;
Heart Valves;
Humans;
Multivariate Analysis;
Recurrence;
Thoracic Surgery
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2019;52(2):61-69
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Scarce data have been reported on the efficacy of concomitant atrial fibrillation (AF) ablation in patients undergoing bioprosthetic valve replacement. METHODS: From 2001 and 2014, 146 consecutive patients (69.3±9.4 years, 84 females) who underwent bioprosthetic heart valve replacement concomitant with AF ablation were assessed. We evaluated long-term rhythm and valve-related outcomes. RESULTS: During 49.1 months of follow-up (interquartile range, 22.5–96.8 months), 7 in-hospital and 49 (6.7% per person-year) post-discharge deaths occurred. The thromboembolic event-free survival rate at 5 years was 79.2%±3.5%. The freedom from AF recurrence rate at 5 years was 59.8%±4.9%. Multivariate analysis showed that old age (hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02–1.11; p=0.002), previous cardiac operation (HR, 3.01; 95% CI, 1.22–7.43; p=0.02), and a large left atrial (LA) dimension (HR, 1.02; 95% CI, 1.00–1.05; p=0.045) were significantly associated with AF recurrence. CONCLUSION: The overall long-term clinical outcomes in these predominantly elderly patients undergoing AF ablation concomitantly with bioprosthetic valve replacement were satisfactory; however, AF recurrence was frequent. Older age, a history of prior cardiac surgery, and large LA size were associated with an increased risk of AF recurrence.
