The long-term influence of lesion set in the surgical ablation of atrial fibrillation during mitral valve surgery: Multicenter propensity-score weighted study

This study aimed to assess the effect of the lesion sets for surgical ablation of atrial fibrillation on long-term outcomes and identify the optimal lesion set. Between 2005 and 2017, 1825 patients underwent surgical ablation concomitant to mitral valve surgery in the participating institutions. Of these, 529 underwent left atrial ablation, whereas the remainder had biatrial ablation. The clinical and rhythm outcomes were compared, considering death as a competing event. Inverse probability treatment weighting was used to mitigate the selection bias. The patients undergoing left atrial ablation were younger and less frequently had long-standing atrial fibrillation with a shorter duration or required concomitant tricuspid valve surgery. Adjusted analysis showed that left atrial ablation was associated with a lower risk of early pacemaker implantation (odds ratio, 0.16; 95% CI, 0.07-0.38; P