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Korean J Thorac Cardiovasc Surg. 2019 Apr;52(2):61-69. doi: 10.5090/kjtcs.2019.52.2.61. Epub 2019 Apr 5.

Surgical Ablation of Atrial Fibrillation in Patients Undergoing Bioprosthetic Valve Replacement.

Author information

1
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

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.

KEYWORDS:

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

Conflict of interest statement

Conflict of interest No potential conflict of interest relevant to this article was reported.

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