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Related Experiment Video

Updated: Jan 24, 2026

Robotic Ablation of Atrial Fibrillation

Robotic Ablation of Atrial Fibrillation

Published on: May 29, 2015

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation.

Joseph J DeRose¹, Donna M Mancini², Helena L Chang²

¹Department of Cardiothoracic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, New York.

Journal of the American College of Cardiology

|May 18, 2019

Summary

Permanent pacemaker implantation is more common after mitral valve surgery with atrial fibrillation ablation. This procedure increases the risk of one-year mortality, highlighting the need for careful patient selection.

Keywords:

biatrial maze cardiac surgery permanent pacemaker pulmonary vein isolation valvular heart disease

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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

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Published on: May 26, 2023

Area of Science:

Cardiology
Cardiac Surgery
Electrophysiology

Background:

Mitral valve surgery (MVS) with concomitant ablation for atrial fibrillation (AF) leads to a higher incidence of permanent pacemaker (PPM) implantation compared to MVS alone.
Understanding the risk factors and outcomes associated with PPM implantation in this patient population is crucial for clinical decision-making.

Purpose of the Study:

To identify independent risk factors for PPM implantation in patients undergoing MVS with or without AF ablation.
To evaluate the impact of PPM implantation on postoperative outcomes, including length of stay, readmissions, and 1-year mortality.

Main Methods:

A randomized trial involving 243 patients with AF undergoing MVS without prior PPM placement.
Patients were assigned to either MVS alone or MVS with ablation (pulmonary vein isolation or biatrial maze).
Competing risk models were used to analyze the association between PPM implantation and various risk factors, as well as its effect on clinical outcomes.

Main Results:

The overall PPM implantation rate within one year was 14.4%, with 83% occurring during the initial hospitalization.
Independent risk factors for PPM implantation included AF ablation, multivalve surgery, and NYHA functional class III/IV.
PPM implantation was associated with a significantly increased risk of 1-year mortality (HR: 3.21; p=0.05).

Conclusions:

Atrial fibrillation ablation, multivalve surgery, and advanced NYHA functional class are significant risk factors for permanent pacemaker implantation after MVS.
Permanent pacemaker implantation following MVS is associated with a substantial increase in 1-year mortality.