Impact of Concomitant Surgical Atrial Fibrillation Ablation in Patients Undergoing Aortic Valve Replacement
- Authors
- Yoo, Jae Suk; Kim, Joon Bum; Ro, Sun Kyun; Jung, Yoonsuh; Jung, Sung-Ho; Choo, Suk Jung; Lee, Jae Won; Chung, Cheol Hyun
- Issue Date
- Jun-2014
- Publisher
- JAPANESE CIRCULATION SOC
- Keywords
- Aortic valve replacement; Atrial fibrillation; Maze procedure
- Citation
- CIRCULATION JOURNAL, v.78, no.6, pp.1364 - 1371
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION JOURNAL
- Volume
- 78
- Number
- 6
- Start Page
- 1364
- End Page
- 1371
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/159840
- DOI
- 10.1253/circj.CJ-13-1533
- ISSN
- 1346-9843
- Abstract
- Background: The clinical benefit of concomitant atrial fibrillation (AF) ablation at the time of aortic valve replacement (AVR) is uncertain. Methods and Results: A total of 124 patients with AF who underwent AVR with (n=50) or without (n=74) a concomitant maze procedure, between 2000 and 2011, were evaluated. There were no significant differences in early postoperative outcomes. During a median clinical follow-up of 18.1 months (interquartile range: 6.9-47.8 months), 19 late deaths (15.3%) and 33 valve-related complications (26.6%) occurred, but the differences between groups were not statistically significant. Major event-free survival at 5 years was 60.9 +/- 9.9% vs. 57.0 +/- 10.3% (P=0.41). After adjustment, the maze group demonstrated similar risks for major adverse cardiac events (hazard ratio, 1.18; 95% confidence interval, 0.56-2.49; P=0.67). However, the rate of sinus rhythm restoration at 4 years was significantly higher in the maze group (80.6% vs. 3.6%, P<0.001). Left atrial dimension was smaller (46.9 vs. 50.4 mm, P=0.017), and the ejection fraction was higher (60.6% vs. 58.0%, P=0.059) in the maze group. The rate of postoperative anticoagulation was also lower in the maze group (53.1% vs. 89.2%, P<0.001). Conclusions: Concomitant AF ablation in patients undergoing AVR resulted in increased sinus rhythm restoration, better echocardiographic results, and decreased anticoagulation requirement, without increasing surgical morbidity or mortality.
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