Objective: Atrial fibrillation (AF) surgical ablation is widely used procedure We describe late follow up of the surgical AF ablation performed in the Sheba Medical Center and factors influencing the AF recurrence years after the ablation.
Methods: Between 2004 and 2014 we performed AF ablation using cryoprobe with or without bipolar radiofrequency ablator as a part of another cardiac surgery in 381 patients. Patients were 63±11 years of age. 122 (32%) patients had long-standing persistent and 198 (52%) persistent atrial fibrillation. 42 (11%) had left atrial volume >200 cc. 264 (69%) of patients underwent mitral valve surgery. 79% had left atrial ablation and 21% biatrial ablation.
Results: Operative mortality was 1% (4 patients). Mean follow up was 37±27 months (range 1-117 months). The follow up was performed by electro-physiologists and surgeons. Sinus rhythm was found in 89%, 84%, 86%, and 78% of patients at 6 month, 1, 2, and 5 years after the ablation correspondently. 80%, 86%, 81%, and 87% of patients was free from antiarrhythmic medications at 6 month, 1, 2, and 5 years after the ablation correspondently. The only patient factor related to ablation failure in the late follow-up was duration of AF pre-ablation (p=0.033). The type of AF pre-ablation, left atrial size, age and other demographic parameters were not found to be related to AF recurrence.
Conclusions: The surgical AF ablation seems to provide excellent freedom form atrial fibrillation and freedom from antyarrhythmic drugs in the late follow up. Patients with long history of AF before the ablation can be expected to have a high rate of AF recurrence in the late follow-up.
