Korean J Thorac Cardiovasc Surg.  2019 Apr;52(2):61-69. 10.5090/kjtcs.2019.52.2.61.

Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement

• Pyo W
• Park SJ
• Kim WK
• Kim HJ
• Kim JB
• Jung SH
• Joo SJ
• Chung CH
• Lee JW

• KMID: 2447604
• DOI: http://doi.org/10.5090/kjtcs.2019.52.2.61

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.

Keyword

Arrhythmia surgery; Anticoagulants; Bioprosthesis; Atrial fibrillation; Surgical ablation

MeSH Terms

Aged
Anticoagulants
Atrial Fibrillation*
Bioprosthesis
Disease-Free Survival
Follow-Up Studies
Freedom
Heart Valves
Humans
Multivariate Analysis
Recurrence
Thoracic Surgery
Anticoagulants