Persistent atrial fibrillation ablation concomitant to coronary surgery.

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Persistent atrial fibrillation (pAF) often coexists with coronary artery disease, necessitating combined surgical approaches.
• Atrial fibrillation ablation concomitant to cardiac surgery aims to restore sinus rhythm and improve outcomes.

Purpose of the Study:

• To evaluate the efficacy of persistent atrial fibrillation (pAF) ablation performed concurrently with coronary artery bypass grafting (CABG).
• To identify preoperative risk factors associated with pAF recurrence after combined surgery.

Main Methods:

• Radiofrequency ablation was performed in 126 patients with pAF undergoing coronary surgery.
• Procedures included pulmonary vein isolation and connecting lesions.
• Patients were assessed at discharge, 3 months, and 3 years post-surgery.

Main Results:

• Stable sinus rhythm (SR) was achieved in 75.9% of surviving patients at 3 years.
• Long-term pAF duration (>5 years) and larger left atrium (LA) size (>50 mm) were significant predictors of pAF recurrence (P < 0.01).
• Early rhythm status at 3 months predicted long-term success.

Conclusions:

• Preoperative pAF duration and LA size are key predictors of successful ablation outcomes in patients undergoing concomitant coronary surgery.
• Shorter pAF duration and smaller LA size significantly increase the likelihood of achieving stable sinus rhythm.