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Surgical ablation of atrial fibrillation trends and outcomes in North America.

Publication ,  Journal Article
Ad, N; Suri, RM; Gammie, JS; Sheng, S; O'Brien, SM; Henry, L
Published in: J Thorac Cardiovasc Surg
November 2012

OBJECTIVE: Despite growing awareness of the clinical significance of atrial fibrillation (AF) and observational data demonstrating the safety and efficacy of surgical therapy, AF ablation is variably performed among patients with AF undergoing cardiac surgery. We examined the national trends of surgical ablation and perioperative outcomes for stand-alone surgical ablation of AF. METHODS: Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, 91,801 (2005-2010) surgical AF ablations were performed of which 4893 (5.3%) were stand-alone procedures. The outcomes of 854 propensity-matched pairs having "on" versus "off" cardiopulmonary bypass stand-alone ablation were compared. RESULTS: The percentage of patients with preoperative AF increased from 2005 to 2010 (from 10.0% to 12.2%). Overall, 40.6% of patients with AF underwent concomitant surgical ablation-a significant decline of 1.6% from 2005 to 2010. The number of stand-alone surgical ablations increased significantly from 552 to 1041 cases (2005-2010). Overall, the stand-alone group had a mean age of 60 years, 71% were men, and 80% were treated "off" cardiopulmonary bypass. The "on" cardiopulmonary bypass group had significantly more pulmonary disease, diabetes, and congestive heart failure. Overall, the operative mortality and stroke rate was 0.7% for each. After propensity matching, the "off" cardiopulmonary bypass group underwent significantly fewer reoperations for bleeding and had a lower incidence of prolonged ventilation and shorter hospitalization. New pacemaker implantation was low, without group differences. CONCLUSIONS: The prevalence of AF in patients undergoing cardiac surgery has increased, as has the number of stand-alone surgical ablations. The treatment of concomitant disease declined slightly. Isolated surgical ablation is safe, performed "on" or "off" cardiopulmonary bypass. These results support consideration of surgical AF ablation as an alternative to percutaneous ablation for patients with lone AF.

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Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

November 2012

Volume

144

Issue

5

Start / End Page

1051 / 1060

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Respiration, Artificial
  • Reoperation
  • Propensity Score
  • Prevalence
 

Citation

APA
Chicago
ICMJE
MLA
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Ad, N., Suri, R. M., Gammie, J. S., Sheng, S., O’Brien, S. M., & Henry, L. (2012). Surgical ablation of atrial fibrillation trends and outcomes in North America. J Thorac Cardiovasc Surg, 144(5), 1051–1060. https://doi.org/10.1016/j.jtcvs.2012.07.065
Ad, Niv, Rakesh M. Suri, James S. Gammie, Shubin Sheng, Sean M. O’Brien, and Linda Henry. “Surgical ablation of atrial fibrillation trends and outcomes in North America.J Thorac Cardiovasc Surg 144, no. 5 (November 2012): 1051–60. https://doi.org/10.1016/j.jtcvs.2012.07.065.
Ad N, Suri RM, Gammie JS, Sheng S, O’Brien SM, Henry L. Surgical ablation of atrial fibrillation trends and outcomes in North America. J Thorac Cardiovasc Surg. 2012 Nov;144(5):1051–60.
Ad, Niv, et al. “Surgical ablation of atrial fibrillation trends and outcomes in North America.J Thorac Cardiovasc Surg, vol. 144, no. 5, Nov. 2012, pp. 1051–60. Pubmed, doi:10.1016/j.jtcvs.2012.07.065.
Ad N, Suri RM, Gammie JS, Sheng S, O’Brien SM, Henry L. Surgical ablation of atrial fibrillation trends and outcomes in North America. J Thorac Cardiovasc Surg. 2012 Nov;144(5):1051–1060.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

EISSN

1097-685X

Publication Date

November 2012

Volume

144

Issue

5

Start / End Page

1051 / 1060

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Respiratory System
  • Respiration, Artificial
  • Reoperation
  • Propensity Score
  • Prevalence