Do Episodes of Atrial Fibrillation within First Week after Surgical Ablation Predict Recurrence of Atrial Fibrillation in the Mid-Term Follow-up?

Objective:
While surgical ablation of atrial fibrillation (AF) is currently a well-established procedure, some issues remain unsolved; one of them is a significance of recurrence of atrial fibrillation during the first days after the procedure.

Methods:
We checked 100 consecutive patients with at least 2 years follow-up after concomitant surgical ablation of atrial fibrillation. All patients underwent an AF ablation using the same technique of cryo ablation with the box lesion in the left atrium and an addition of the mitral line. All patients were operated on in 2012-2014.

Results:
78 patients had no AF episodes within first week after surgery, 22 patients suffered from AF during hospitalization. Age, gender, functional class, type and length of AF before surgery were similar in both groups. Only 18% of patients with no AF episodes and 13% of patients with AF episodes within the first week after ablation suffered from paroxysmal AF before surgery, other patients had persistent or long-standing persistent atrial fibrillation (p=0.56). Left atrial size and left ventricle function were also similar in patients groups, as well as the type of concomitant procedures: mitral valve repair and replacement, coronary bypass etc. Among patients without AF episodes in the first week after surgery 96% and 94% were in sinus rhythm at 1 and 2 years follow-up correspondently versus 67% and 77% of patients from the group with early recurrence of atrial fibrillation (p=0.001 at the first year and p=0.039 at the second year of follow-up).

Conclusions:
Atrial fibrillation episodes during first week after surgical ablation predict recurrent AF in the mid-term follow-up.