Early recurrence is a predictor of late failure in surgical ablation of atrial fibrillation

Interact Cardiovasc Thorac Surg. 2011 May;12(5):681-6. doi: 10.1510/icvts.2010.261842. Epub 2011 Feb 22.

Abstract

We sought to determine if early recurrence of atrial fibrillation (AF) after surgical ablation is a risk factor of late failure. Between February 2004 to May 2009, 106 patients underwent surgical ablation of concomitant permanent AF with radiofrequency. Operations primarily consisted of valve surgery in 85% of patients. Hospital mortality was 2.8% (n = 3). The median follow-up was 37 months (interquartile rank 12-77), and was complete in 99% of patients. Freedom from AF was 82%, 76% and 68% at one, two and three years, respectively. Patients with early recurrence of AF had less prevalence of sinus rhythm in late follow-up (P < 0.001). Multivariate Cox regression analysis showed that AF duration [hazard ratio (HR) 1.014, 95% CI 1.009-1.020, P < 0.001] and early recurrence of AF (HR 3.45, 95% CI 1.50-7.95, P = 0.004) were independent risk factors for failure. In conclusion, in our series, early recurrence of AF after surgical ablation is a strong predictor of late failure.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / mortality
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / adverse effects*
  • Catheter Ablation / mortality
  • Chi-Square Distribution
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Hospital Mortality
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Spain
  • Time Factors
  • Treatment Failure