Early postsurgical AF as a predicator for surgical ablation success

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia and associated with increased risk for morbidity and mortality. After surgical ablation the scar formation may take up to 6 months to form for the success of the procedure.

Post ablation AF may occur in the early postoperative period, however the evidence for its significance for the success of the ablation is unclear.

Objectives

The main objective of this study is to determine the significance of early postoperative AF for the prediction of the ablation success in the long term.

Methods

Between June 2009 and November 2018, 292 consecutive patients underwent concomitant or isolated surgical AF ablation procedure. 17% of patients with permanent AF, 66% persistent and 16% paroxysmal AF.

66.5% of patients were diagnosed with AF in the postoperative early days (AF group), whereas 33.5% were free of AF throughout the entire early postoperative period, till discharge (Non-AF group). Mean age was 62±10 years and 64±10 years in the Non-AF and AF groups respectively (p=0.056). In the Non AF group 65% were men.

All patients were prospectively followed and long term clinical and echocardiographic outcomes were compared and analyzed.

Results

In Non-AF group, fewer ICU and hospital days were found (P= 0.012 and P

Long term results showed no significance in the success of the procedure between the AF group versus the Non AF group – 39 (98%) and 64 (93%) respectively, and showed no long term benefit for the Non AF group.

The long term results after 6 months were 95% persistent sinus rhythm.

Conclusions

Early postoperative AF after surgical ablation has no predictive value for the long term procedure success.