Biatrial ablation vs. Pulmonary vein isolation in atrial fibrillation patients undergoing cardiac surgery: a retrospective study

Hald, Mine Onat; Lauritzen, Daniel Julius; Heiberg, Johan; Juhl, Winnie; Moss, Emmanuel; Vodstrup, Henrik J

doi:10.1080/14017431.2020.1846775

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…В ретроспективном исследовании [10], включавшем пациентов с персистирующей и длительно персистирующей формами ФП, где сравнивались двухпредсердная и изолированная аблация легочных вен, была показана эффективность биатриальной аблации (63%) в длительном сохранении синусового ритма по сравнению с аблацией легочных вен (45%); р = 0,039.…”

Section: Discussionunclassified

Comparative efficacy and safety of biatrial versus left atrial ablation in the surgical treatment of long-standing persistent atrial fibrillation with concomitant coronary artery bypass grafting in patients with ischemic heart disease

Калыбекова

Рахмонов

Lukinov

et al. 2021

SMJ

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Purpose. To compare the results of biatrial (BA) and left atrial ablation (LAA) performed in patients with long-standing persistent atrial fibrillation (AF) with concomitant coronary artery disease (CAD) with indication for coronary artery bypass grafting (CABG).Material and Methods. A prospective, randomized, single-center, blinded study was conducted on the basis Meshalkin National Medical Research Center in the period from 2016 to 2019. A total of 116 patients with long-standing persistent AF and CAD were randomized into two groups: BA + CABG group (n = 58) and LAA + CABG group (n = 58). Patients of both groups underwent CABG surgery with the chosen atrial ablation technique (LAA or BA).Results: BA technique proved to be more effective in maintaining sinus rhythm (58%) compared with isolated LAA (31%) at 24 months (p = 0.019) after surgical treatment of long-standing persistent AF with concomitant CABG.Conclusion: BA technique was more effective than isolated LAA in the late postoperative period of 24 months.

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Section: Discussionunclassified

Comparative efficacy and safety of biatrial versus left atrial ablation in the surgical treatment of long-standing persistent atrial fibrillation with concomitant coronary artery bypass grafting in patients with ischemic heart disease

Калыбекова

Рахмонов

Lukinov

et al. 2021

SMJ

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Surgical management of atrial fibrillation in patients undergoing cardiac surgery: a systematic review of clinical practice guidelines and recommendations

Kumar,

Khanji,

Patel

et al. 2023

European Heart Journal - Quality of Care and Clinical Outcomes

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Aims Surgical ablation of atrial fibrillation (AF) has been demonstrated to be a safe procedure conducted concomitantly alongside cardiac surgery. However, there are conflicting guideline recommendations surrounding indications for surgical ablation. We conducted a systematic review of current recommendations on concomitant surgical AF ablation. Methods and results We identified publications from MEDLINE and EMBASE between January 2011 and December 2022 and additionally searched Guideline libraries and websites of relevant organisations in accordance with PRISMA guidelines. Of 895 studies screened, 4 were rigorously developed (AGREE-II > 50%) and included. All guidelines agreed on the definitions of paroxysmal, persistent, and longstanding AF based on duration and refraction to current treatment modalities. In the Australia-New Zealand (CSANZ) and European (EACTS) guidelines, opportunistic screening for patients > 65 years is recommended. The EACTS recommends systematic screening for those aged > 75 or at high stroke risk (Class IIa, Level B). However, this was not recommended by AHA or STS guidelines. All guidelines identified surgical AF ablation during concomitant cardiac surgery as safe and recommended for consideration by a Heart Team with notable variation in recommendation strength and the specific indication (3 guidelines fail to specify any indication for surgery). Only the STS recommended left atrial appendage occlusion (LAAO) alongside surgical ablation (Class IIA, Level C). Conclusion Disagreements exist in recommendations for specific indications for concomitant AF ablation and LAAO, with the decision subject to Heart Team assessment. Further evidence is needed to develop recommendations for specific indications for concomitant AF procedures and guidelines need to be made congruent.

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Three Ablation Techniques for Atrial Fibrillation during Concomitant Cardiac Surgery: A Systematic Review and Network Meta-Analysis

Hanafy,

Erdianto,

Husen

et al. 2023

JCM

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Atrial fibrillation (AF) ablation is a frequent procedure used in concomitant cardiac surgery. However, uncertainty still exists concerning the optimal extent of lesion sets. Hence, the objective of this study was to assess the results of various ablation techniques, aiming to offer a reference for clinical decision making. This review is listed in the prospective register of systematic reviews (PROSPERO) under ID CRD42023412785. A comprehensive search was conducted across eight databases (Scopus, Google Scholar, EBSCOHost, PubMed, Medline, Wiley, ProQuest, and Embase) up to 18 April 2023. Studies were critically appraised using the Cochrane Risk of Bias 2.0 for randomized control trials (RCTs) and the Newcastle Ottawa Scale adapted by the Agency for Healthcare Research and Quality (AHRQ) for cohort studies. Forest plots of pooled effect estimates and surface under the cumulative ranking (SUCRA) were used for the analysis. Our analysis included 39 studies and a total of 7207 patients. Both bi-atrial ablation (BAA) and left atrial ablation (LAA) showed similar efficacy in restoring sinus rhythm (SR; BAA (77.9%) > LAA (76.2%) > pulmonary vein isolation (PVI; 66.5%); LAA: OR = 1.08 (CI 0.94–1.23); PVI: OR = 1.36 (CI 1.08–1.70)). However, BAA had higher pacemaker implantation (LAA: OR = 0.51 (CI 0.37–0.71); PVI: OR = 0.52 (CI 0.31–0.86)) and reoperation rates (LAA: OR = 0.71 (CI 0.28–1.45); PVI: OR = 0.31 (CI 0.1–0.64)). PVI had the lowest efficacy in restoring SR and a similar complication rate to LAA, but had the shortest procedure time (Cross-clamp (Xc): PVI (93.38) > LAA (37.36) > BAA (13.89)); Cardiopulmonary bypass (CPB): PVI (93.93) > LAA (56.04) > BAA (0.03)). We suggest that LAA is the best surgical technique for AF ablation due to its comparable effectiveness in restoring SR, its lower rate of pacemaker requirement, and its lower reoperation rate compared to BAA. Furthermore, LAA ranks as the second-fastest procedure after PVI, with a similar CPB time.

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Biatrial ablation vs. Pulmonary vein isolation in atrial fibrillation patients undergoing cardiac surgery: a retrospective study

Cited by 3 publications

References 25 publications

Comparative efficacy and safety of biatrial versus left atrial ablation in the surgical treatment of long-standing persistent atrial fibrillation with concomitant coronary artery bypass grafting in patients with ischemic heart disease

Comparative efficacy and safety of biatrial versus left atrial ablation in the surgical treatment of long-standing persistent atrial fibrillation with concomitant coronary artery bypass grafting in patients with ischemic heart disease

Surgical management of atrial fibrillation in patients undergoing cardiac surgery: a systematic review of clinical practice guidelines and recommendations

Three Ablation Techniques for Atrial Fibrillation during Concomitant Cardiac Surgery: A Systematic Review and Network Meta-Analysis

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