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Updated: Mar 6, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Should We Ablate Atrial Fibrillation During Coronary Artery Bypass Grafting and Aortic Valve Replacement?
Talal Al-Atassi1, Donna-May Kimmaliardjuk1, Camille Dagenais1
1Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Insights
Concomitant atrial fibrillation (AF) ablation during heart surgery is safe and effective. It significantly reduces postoperative AF and improves long-term freedom from AF without increasing mortality or morbidity.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) is common in patients undergoing cardiac surgery.
- Evaluating concomitant AF ablation during coronary artery bypass grafting (CABG) or aortic valve replacement (AVR) is crucial.
Purpose of the Study:
- To assess the safety and efficacy of performing AF ablation concurrently with CABG or AVR.
- To determine the impact on perioperative outcomes and long-term AF recurrence.
Main Methods:
- Single-center retrospective study (2009-2013) of 375 patients with AF.
- Comparison between an ablation group (n=129) and a control group (n=246).
- Data collected via telephone interviews with a median 30-month follow-up.
Main Results:
- Concomitant ablation increased cardiopulmonary bypass and cross-clamp times but showed similar rates of mortality, stroke, and reopening.
- The ablation group had significantly lower postoperative AF (27% vs. 78%, p < 0.01).
- Mid-term AF-free survival was higher in the ablation group (p < 0.01).
Conclusions:
- Concomitant AF ablation is safe, not increasing perioperative mortality or morbidity.
- It effectively reduces postoperative AF burden.
- It improves mid-term AF-free survival in patients undergoing CABG or AVR.
Background:
This study evaluates the safety and efficacy of concomitant atrial fibrillation (AF) ablation in patients with AF undergoing coronary artery bypass grafting (CABG) or aortic valve replacement (AVR) or both.
Methods:
This is a single-center retrospective study of patients with AF presenting for CABG or AVR or both between 2009 and 2013. They were divided into an ablation group that underwent concomitant AF ablation and a control group that did not. Follow-up data were obtained using telephone interviews. The data were 100% complete with a median follow-up of 30 months.
Results:
A total of 375 patients with AF presented for CABG (44%), AVR (27%), or CABG and AVR (29%). The ablation (129 patients) and control (246 patients) groups had similar baseline characteristics. The ablation group had significantly longer cardiopulmonary bypass and cross-clamp times, adding a mean of 31 ± 3 and 22 ± 3 minutes (p < 0.01 for both), respectively. There were similar unadjusted rates of hospital mortality (4.7% versus 5.3%, p = 0.79), stroke (3.1% versus 3.3%, p = 0.94), and reopening (4.7% versus 6.5%, p = 0.46) between the groups. The intensive care and hospital length of stays were similar. The ablation group had a lower incidence of postoperative AF (27% versus 78%, p < 0.01). Adjusted operative mortality was similar, but the intervention group had significantly lower odds of postoperative AF (odds ratio 0.11, p < 0.01). Although there was no difference in mid-term survival, the ablation group had higher mid-term AF-free survival (p < 0.01) and a trend toward higher anticoagulation-free (p = 0.09) and stroke-free survival (p = 0.08).
Conclusions:
Concomitant AF ablation in patients with AF undergoing CABG or AVR or both does not increase perioperative rates of mortality or morbidity. Moreover, concomitant AF ablation is effective at reducing postoperative AF burden and increases mid-term AF-free survival.
