Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience
Objectives Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. Methods From Janua...
Gespeichert in:
| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2014-08, Vol.148 (2), p.428-433 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 433 |
|---|---|
| container_issue | 2 |
| container_start_page | 428 |
| container_title | The Journal of thoracic and cardiovascular surgery |
| container_volume | 148 |
| creator | Pecha, Simon, MD Schäfer, Timm, MD Subbotina, Irina, MD Ahmadzade, Teymour, MD Reichenspurner, Hermann, MD, PhD Wagner, Florian Mathias, MD |
| description | Objectives Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. Methods From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation. Results The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter ( P = .0019), AF duration ( P = .018), and immediate postoperative SR ( P |
| doi_str_mv | 10.1016/j.jtcvs.2013.08.074 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1546217229</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522313010714</els_id><sourcerecordid>1546217229</sourcerecordid><originalsourceid>FETCH-LOGICAL-c529t-84ce20736d5c5152d48cb03e75a00dae5f8d2627826fb09fd90f8ae2770b458d3</originalsourceid><addsrcrecordid>eNqFkV-L1TAQxYMo7nX1EwiSRx9snaRNkwoKy-KuwoLgH_AtpMl0N7W3uSbpYr-97d7VB198Gpg5Zyb5HUKeMygZsOb1UA7Z3qaSA6tKUCXI-gHZMWhl0Sjx_SHZAXBeCM6rE_IkpQEAJLD2MTnhNata1codWT7fLPlmT8OcbdgjPUR03uYQEzV9xkhtmNaBz2bKNM3x2lszUtONJvsw0T5EanL0a6_3XfTjsf-GntG2WNDEVzT56XrEwuK0rcNfB4weJ4tPyaPejAmf3ddT8u3i_dfzD8XVp8uP52dXhRW8zYWqLXKQVeOEFUxwVyvbQYVSGABnUPTK8YZLxZu-g7Z3LfTKIJcSulooV52Sl8e9hxh-zpiy3vtkcX3phGFOmom64Uxy3q7S6ii1MaQUsdeH6PcmLpqB3pjrQd8x1xtzDUqvzFfXi_sDc7dH99fzB_IqeHsU4PrNW49RJ3uHwPmINmsX_H8OvPvHb0c_bUH8wAXTEOY4rQQ104lr0F-22LfUWQUMJKur36ovqo0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1546217229</pqid></control><display><type>article</type><title>Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Pecha, Simon, MD ; Schäfer, Timm, MD ; Subbotina, Irina, MD ; Ahmadzade, Teymour, MD ; Reichenspurner, Hermann, MD, PhD ; Wagner, Florian Mathias, MD</creator><creatorcontrib>Pecha, Simon, MD ; Schäfer, Timm, MD ; Subbotina, Irina, MD ; Ahmadzade, Teymour, MD ; Reichenspurner, Hermann, MD, PhD ; Wagner, Florian Mathias, MD</creatorcontrib><description>Objectives Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. Methods From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation. Results The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter ( P = .0019), AF duration ( P = .018), and immediate postoperative SR ( P < .001). Regarding only patients with persistent or longstanding-persistent AF, those with biatrial lesions had significantly greater rates of conversion to SR than those with solitary left atrial ablation (SR, 64.9% vs 51.4%; P = .044) after 12 months. Conclusions The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2013.08.074</identifier><identifier>PMID: 24139897</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Aged ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - mortality ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Cardiothoracic Surgery ; Catheter Ablation - adverse effects ; Catheter Ablation - mortality ; Coronary Artery Bypass ; Disease-Free Survival ; Electrocardiography, Ambulatory ; Female ; Germany ; Heart Atria - physiopathology ; Heart Atria - surgery ; Heart Valve Prosthesis Implantation ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pulmonary Veins - physiopathology ; Pulmonary Veins - surgery ; Retrospective Studies ; Time Factors ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2014-08, Vol.148 (2), p.428-433</ispartof><rights>The American Association for Thoracic Surgery</rights><rights>2014 The American Association for Thoracic Surgery</rights><rights>Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c529t-84ce20736d5c5152d48cb03e75a00dae5f8d2627826fb09fd90f8ae2770b458d3</citedby><cites>FETCH-LOGICAL-c529t-84ce20736d5c5152d48cb03e75a00dae5f8d2627826fb09fd90f8ae2770b458d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522313010714$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24139897$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pecha, Simon, MD</creatorcontrib><creatorcontrib>Schäfer, Timm, MD</creatorcontrib><creatorcontrib>Subbotina, Irina, MD</creatorcontrib><creatorcontrib>Ahmadzade, Teymour, MD</creatorcontrib><creatorcontrib>Reichenspurner, Hermann, MD, PhD</creatorcontrib><creatorcontrib>Wagner, Florian Mathias, MD</creatorcontrib><title>Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objectives Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. Methods From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation. Results The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter ( P = .0019), AF duration ( P = .018), and immediate postoperative SR ( P < .001). Regarding only patients with persistent or longstanding-persistent AF, those with biatrial lesions had significantly greater rates of conversion to SR than those with solitary left atrial ablation (SR, 64.9% vs 51.4%; P = .044) after 12 months. Conclusions The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.</description><subject>Aged</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - mortality</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Cardiothoracic Surgery</subject><subject>Catheter Ablation - adverse effects</subject><subject>Catheter Ablation - mortality</subject><subject>Coronary Artery Bypass</subject><subject>Disease-Free Survival</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Germany</subject><subject>Heart Atria - physiopathology</subject><subject>Heart Atria - surgery</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Veins - physiopathology</subject><subject>Pulmonary Veins - surgery</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV-L1TAQxYMo7nX1EwiSRx9snaRNkwoKy-KuwoLgH_AtpMl0N7W3uSbpYr-97d7VB198Gpg5Zyb5HUKeMygZsOb1UA7Z3qaSA6tKUCXI-gHZMWhl0Sjx_SHZAXBeCM6rE_IkpQEAJLD2MTnhNata1codWT7fLPlmT8OcbdgjPUR03uYQEzV9xkhtmNaBz2bKNM3x2lszUtONJvsw0T5EanL0a6_3XfTjsf-GntG2WNDEVzT56XrEwuK0rcNfB4weJ4tPyaPejAmf3ddT8u3i_dfzD8XVp8uP52dXhRW8zYWqLXKQVeOEFUxwVyvbQYVSGABnUPTK8YZLxZu-g7Z3LfTKIJcSulooV52Sl8e9hxh-zpiy3vtkcX3phGFOmom64Uxy3q7S6ii1MaQUsdeH6PcmLpqB3pjrQd8x1xtzDUqvzFfXi_sDc7dH99fzB_IqeHsU4PrNW49RJ3uHwPmINmsX_H8OvPvHb0c_bUH8wAXTEOY4rQQ104lr0F-22LfUWQUMJKur36ovqo0</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Pecha, Simon, MD</creator><creator>Schäfer, Timm, MD</creator><creator>Subbotina, Irina, MD</creator><creator>Ahmadzade, Teymour, MD</creator><creator>Reichenspurner, Hermann, MD, PhD</creator><creator>Wagner, Florian Mathias, MD</creator><general>Mosby, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience</title><author>Pecha, Simon, MD ; Schäfer, Timm, MD ; Subbotina, Irina, MD ; Ahmadzade, Teymour, MD ; Reichenspurner, Hermann, MD, PhD ; Wagner, Florian Mathias, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c529t-84ce20736d5c5152d48cb03e75a00dae5f8d2627826fb09fd90f8ae2770b458d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - mortality</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Cardiothoracic Surgery</topic><topic>Catheter Ablation - adverse effects</topic><topic>Catheter Ablation - mortality</topic><topic>Coronary Artery Bypass</topic><topic>Disease-Free Survival</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Germany</topic><topic>Heart Atria - physiopathology</topic><topic>Heart Atria - surgery</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Veins - physiopathology</topic><topic>Pulmonary Veins - surgery</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pecha, Simon, MD</creatorcontrib><creatorcontrib>Schäfer, Timm, MD</creatorcontrib><creatorcontrib>Subbotina, Irina, MD</creatorcontrib><creatorcontrib>Ahmadzade, Teymour, MD</creatorcontrib><creatorcontrib>Reichenspurner, Hermann, MD, PhD</creatorcontrib><creatorcontrib>Wagner, Florian Mathias, MD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pecha, Simon, MD</au><au>Schäfer, Timm, MD</au><au>Subbotina, Irina, MD</au><au>Ahmadzade, Teymour, MD</au><au>Reichenspurner, Hermann, MD, PhD</au><au>Wagner, Florian Mathias, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>148</volume><issue>2</issue><spage>428</spage><epage>433</epage><pages>428-433</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Objectives Concomitant surgical ablation is a safe and feasible procedure, recommended by the guidelines for patients with atrial fibrillation (AF) undergoing cardiac surgery. We performed a single-center data analysis to identify the predictors of rhythm outcome in such patients. Methods From January 2003 to January 2012, 503 patients with persistent (n = 296, 58.8%) or paroxysmal (n = 207, 41.2%) AF underwent concomitant surgical AF ablation. The lesions were limited to a pulmonary vein isolation (n = 76, 15.1%), a more complex left atrial lesion set (n = 353, 70.2%), or biatrial lesions (n = 74, 14.7%). Follow-up rhythm evaluations were based on either 24-hour Holter electrocardiograms or event recorder interrogation at 3, 6, and 12 months postoperatively. A sinus rhythm (SR) immediately postoperatively was defined as the first documented rhythm after weaning from extracorporeal circulation. Results The mean patient age was 68.0 ± 9.5 years, and 336 (66.8%) were men. No major ablation-related complications occurred. After 1 year of follow-up, 59.9% of all patients were in SR, with significantly better results in patients with paroxysmal AF than in those with persistent AF (67.3% vs 54.8%, P = .0053). Additional statistically significant factors influencing SR after 1 year were left atrial diameter ( P = .0019), AF duration ( P = .018), and immediate postoperative SR ( P < .001). Regarding only patients with persistent or longstanding-persistent AF, those with biatrial lesions had significantly greater rates of conversion to SR than those with solitary left atrial ablation (SR, 64.9% vs 51.4%; P = .044) after 12 months. Conclusions The statistically significant predictors for SR after 1 year were left atrial diameter, AF duration, preoperative paroxysmal AF, immediate postoperative SR, and biatrial ablation for persistent AF.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>24139897</pmid><doi>10.1016/j.jtcvs.2013.08.074</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-5223 |
| ispartof | The Journal of thoracic and cardiovascular surgery, 2014-08, Vol.148 (2), p.428-433 |
| issn | 0022-5223 1097-685X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1546217229 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Atrial Fibrillation - diagnosis Atrial Fibrillation - mortality Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Cardiothoracic Surgery Catheter Ablation - adverse effects Catheter Ablation - mortality Coronary Artery Bypass Disease-Free Survival Electrocardiography, Ambulatory Female Germany Heart Atria - physiopathology Heart Atria - surgery Heart Valve Prosthesis Implantation Hospital Mortality Humans Male Middle Aged Pulmonary Veins - physiopathology Pulmonary Veins - surgery Retrospective Studies Time Factors Treatment Outcome |
| title | Rhythm outcome predictors after concomitant surgical ablation for atrial fibrillation: A 9-year, single-center experience |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T15%3A44%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Rhythm%20outcome%20predictors%20after%20concomitant%20surgical%20ablation%20for%20atrial%20fibrillation:%20A%209-year,%20single-center%20experience&rft.jtitle=The%20Journal%20of%20thoracic%20and%20cardiovascular%20surgery&rft.au=Pecha,%20Simon,%20MD&rft.date=2014-08-01&rft.volume=148&rft.issue=2&rft.spage=428&rft.epage=433&rft.pages=428-433&rft.issn=0022-5223&rft.eissn=1097-685X&rft_id=info:doi/10.1016/j.jtcvs.2013.08.074&rft_dat=%3Cproquest_cross%3E1546217229%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1546217229&rft_id=info:pmid/24139897&rft_els_id=S0022522313010714&rfr_iscdi=true |