Predictors for permanent pacemaker implantation after concomitant surgical ablation for atrial fibrillation

Abstract

Concomitant surgical AF ablation showed a pacemaker implantation rate of 6.9% after 30-day follow-up. Univariate and multivariate analysis showed biatrial lesion set as the only statistically significant predictor for pacemaker implantation after surgical AF ablation.

Concomitant Unipolar Radiofrequency Ablation of Nonparoxysmal Atrial Fibrillation in Rheumatic and Degenerative Valve Disease

“…Another group reported a rate of pacemaker implantation at 30 days of 6.9%, in which a biatrial lesion set was the single predictor of pacemaker implantation. This is also in keeping with our finding that most patients undergoing ablation of the right atrial isthmus were requiring pacemaker implantation, which led us to limit this lesion . Therefore, our figures can be driven by these patients who initially underwent right atrial isthmus ablation.…”

Safety and efficacy of biatrial vs left atrial surgical ablation during concomitant cardiac surgery: A meta‐analysis of clinical studies with a focus on the causes of pacemaker implantation

“…3,4,21,22,24,25,27,31,32,37 The remaining 15 studies (53.6%) were retrospective observational, of which 3 were propensity adjusted. 5,19,20,26,[28][29][30]33,34,38,39,[44][45][46][47] In 16 studies (57.1%) all the patients enrolled presented exclusively non-paroxysmal AF forms and these studies constituted the "non-paroxysmal AF subgroup." [20][21][22][23][25][26][27][28][34][35][36][37][38][39]46,47 clearly specify the types of AF included.…”

“…In 10 studies (35.7%) mitral surgery was the main procedure performed in association with AF ablation, 19 Within studies adopting CM4, radiofrequency was the most common energy source used to perform the ablation: it was used in 11 studies (39.3%) as the only source of energy in both study groups, [21][22][23]25,26,34,35,37,44,45,47 while in 5 studies (17.8%) radiofrequency mainly used but it was complemented by cryoablation for some lesions. 19,20,24,30,36 These 16 studies were included in the Radiofrequency subgroup.…”

“…In 16 studies [19][20][21][22][23][24][25][26]30,[34][35][36][37]44,45,47 a CM4 using RF was adopted. The comparison of preoperative and intraoperative characteristics in this subgroup, did not show any significant unbalancing between BA and LA patients characteristics, except the length of cardiopulmonary bypass (WMD 12.16 minutes, CI, 1.53-22.80 minutes, P = .03) that was longer in the BA group (see Supplementary Material S4).…”

Comparative analysis of the requirement for pacemaker implantation in the left atrial and biatrial concomitant ablation in patients with valvular heart disease

“…Недавние исследова-ния, включая два рандомизированных [1,5], вы-явили сопоставимую эффективность как лево-предсердной (ЛП), так и биатриальной (БА) аб-лации [6,7], в то же время другие исследования, включая два метаанализа, показали, что БА-аб-лация способствует более длительной свободе от возврата ФП [4,8,9]. Основным ограничением для выполнения БА-аблации является более вы-сокий риск имплантации искусственного води-теля ритма (электрокардиостимулятора -ЭКС) [6,8,10]. Некоторые авторы утверждают, что БА-аблацию разумно выполнять у пациентов с пер-систирующей или длительно персистирующей ФП [4,11,12].…”