Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement
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...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic and Cardiovascular Surgery
2019-04-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: |
| Summary: | 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. |
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| ISSN: | 2233-601X 2093-6516 |