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...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic and Cardiovascular Surgery
2019-04-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: |
| _version_ | 1818792320756088832 |
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| author | WonKyung Pyo Sung Jun Park Wan Kee Kim |
| author_facet | WonKyung Pyo Sung Jun Park Wan Kee Kim |
| author_sort | WonKyung Pyo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-18T15:25:23Z |
| format | Article |
| id | doaj.art-59220814387a428eae88281723594b0e |
| institution | Directory Open Access Journal |
| issn | 2233-601X 2093-6516 |
| language | English |
| last_indexed | 2024-12-18T15:25:23Z |
| publishDate | 2019-04-01 |
| publisher | Korean Society for Thoracic and Cardiovascular Surgery |
| record_format | Article |
| series | Korean Journal of Thoracic and Cardiovascular Surgery |
| spelling | doaj.art-59220814387a428eae88281723594b0e2022-12-21T21:03:17ZengKorean Society for Thoracic and Cardiovascular SurgeryKorean Journal of Thoracic and Cardiovascular Surgery2233-601X2093-65162019-04-01522616910.5090/kjtcs.2019.52.2.61Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve ReplacementWonKyung Pyo0Sung Jun Park1Wan Kee Kim2Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaAsan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaAsan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground: 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.Arrhythmia surgeryAnticoagulantsBioprosthesisAtrial fibrillationSurgical ablation |
| spellingShingle | WonKyung Pyo Sung Jun Park Wan Kee Kim Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement Korean Journal of Thoracic and Cardiovascular Surgery Arrhythmia surgery Anticoagulants Bioprosthesis Atrial fibrillation Surgical ablation |
| title | Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement |
| title_full | Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement |
| title_fullStr | Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement |
| title_full_unstemmed | Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement |
| title_short | Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement |
| title_sort | surgical ablation of atrial fibrillation in patients undergoing bioprosthetic valve replacement |
| topic | Arrhythmia surgery Anticoagulants Bioprosthesis Atrial fibrillation Surgical ablation |
| work_keys_str_mv | AT wonkyungpyo surgicalablationofatrialfibrillationinpatientsundergoingbioprostheticvalvereplacement AT sungjunpark surgicalablationofatrialfibrillationinpatientsundergoingbioprostheticvalvereplacement AT wankeekim surgicalablationofatrialfibrillationinpatientsundergoingbioprostheticvalvereplacement |