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Updated: Apr 18, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Radiofrequency ablation of atrial fibrillation during concomitant cardiac surgery
Ana C Pinho-Gomes1, Mário J Amorim, Sílvia M Oliveira
1Departmentos de Fisiologia e Cirurgia Cardiotorácica, de Ciências da Informação e da Decisão em Sáude (CIDES), Unidade de Investigação e Desenvolvimento Cardiovascular e Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde (CINTESIS) da Faculdade de Medicina da Universidade do Porto e Departamentos de Cirurgia Cardiotorácica e de Cardiologia do Centro Hospitalar S. João, Porto, Portugal.
Insights
Radiofrequency ablation for atrial fibrillation during cardiac surgery safely restores normal heart rhythm. This combined approach shows good long-term results for patients needing both procedures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia often requiring treatment.
- Concurrent treatment of AF during cardiac surgery can improve patient outcomes.
- Radiofrequency ablation (RFA) is a minimally invasive technique for AF treatment.
Purpose of the Study:
- To evaluate the safety and efficacy of concomitant radiofrequency ablation for atrial fibrillation during cardiac surgery.
- To assess the long-term rhythm control and complication rates associated with the combined procedure.
Main Methods:
- 170 patients underwent concomitant radiofrequency ablation for AF during cardiac surgery.
- Procedures included pulmonary vein isolation and other left atrial ablation lines.
- Patients were followed for 3 months and long-term rhythm monitoring was performed.
Main Results:
- 69% of patients were in sinus rhythm at discharge, and 50% at 3 months.
- Surgical complications were rare, with pacemaker implantation being the most frequent (15%).
- In-hospital mortality was less than 3% and not related to the ablation.
Conclusions:
- Concurrent radiofrequency ablation for AF during cardiac surgery is safe and effective.
- The procedure achieves satisfactory and stable recovery of sinus rhythm.
- This combined approach does not add significant operative risk or post-operative complications.
Objectives:
We present the experience of our centre with radiofrequency ablation of atrial fibrillation concomitantly with cardiac surgery Methods: 170 patients underwent atrial fibrillation ablation with uni/bipolar-radiofrequency. They were followed for 3-months and then as appropriate for the cardiac disease. In 2013, patients still alive underwent rhythm monitoring with ECG and 24-hour tape if in sinus rhythm
Results:
Mean age was 65 years old and 42% of the patients were male. Paroxysmal AF was rare (7%). Most patients had preserved ejection fraction and dilated left atria (diameter 53.2±7.5 mm). The most common indication for cardiac surgery was valve disease. More than 75% of the patients underwent prophylactic closure of the left atrial appendage. Pulmonary vein isolation was performed in all patients, followed by other left atrial ablation lines. Overall, surgical complications were rare, being the most frequent pacemaker implantation (15%). Median length of stay was 9 days (p25-p75:7-14). At discharge, 69% of the patients were in sinus rhythm, being 90% on anticoagulation and 69% on amiodarone. In-hospital mortality was less than 3% (5 patients), none of them related to the ablation procedure. At 3 months, 50% of the patients were in sinus rhythm, being 92% on anticoagulation and 75% on antiarrhythmic drugs. Direct current cardioversion was successful in 8 of 12 patients. In the multivariate analysis, being in sinus rhythm at discharge was the single independent predictor of maintaining sinus rhythm at 3 months. In 2013 (469 patients-year), 40% of the patients were in sinus rhythm, being 80% on anticoagulation and 45% on antiarrhythmic drugs.
Conclusions:
Concurrent atrial fibrillation ablation with radiofrequency achieves satisfactory and stable recovery of sinu rhythm without adding significant operative risk and post-operative complications.
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