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Updated: Oct 20, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Outcome of concomitant left atrial ablation during valvular heart surgery: an African perspective
Dambuza Nyamande1, Risenga F Chauke1, Siphosenkosi M Mazibuko1
1Department of Cardiothoracic Surgery, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa.
Insights
Left atrial radiofrequency ablation during heart valve surgery is effective for treating atrial fibrillation. Success rates improve over time, with pre-operative ejection fraction being a key predictor.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation is a common arrhythmia often treated with medication or ablation.
- Surgical ablation for atrial fibrillation during heart valve surgery is an option for select patients.
Purpose of the Study:
- To evaluate the success rates of left atrial radiofrequency cardiac ablation for atrial fibrillation in patients undergoing heart valve surgery.
- To identify predictors of success for this combined procedure.
Main Methods:
- Retrospective study of 53 patients undergoing valve surgery and concomitant left atrial radiofrequency ablation.
- Outcomes assessed at multiple time points (3-24 months) post-procedure.
- Statistical analysis using Z-test to compare outcomes against a 50:50 chance probability.
Main Results:
- Immediate success (sinus rhythm) was achieved in 56.9% of patients, with rates increasing over time.
- Long-term rhythm stability was determined between 3 and 6 months post-ablation.
- Pre-operative reduced ejection fraction was the sole identified predictor of lower ablation success rates.
Conclusions:
- Concomitant left atrial ablation during heart valve surgery demonstrates efficacy in managing atrial fibrillation.
- Routine post-operative anti-arrhythmic medication is not advised following successful surgical ablation.
Objectives:
The aim of this study was to determine the success rates of left atrial radiofrequency cardiac ablation for atrial fibrillation during heart valve surgery.
Methods:
This was a three-year retrospective study of 53 patients who had valve surgery and cardio-ablation. Immediate and long-term overall outcomes were analysed at three, six, nine, 12 and 24 months. The results were tested for significance by comparing to a chance outcome (50:50 probability) using the Z-test for the normal approximation of the binomial distribution.
Results:
A total of 56.9% of patients converted immediately to sinus rhythm, with that number increasing over time. Pre-operative poor ejection fraction was the only predictor of low success rates following ablation. Long-term rhythm was determined by the patient's rhythm between three and six months.
Conclusions:
Concomitant left atrial ablation during valve surgery is effective in treating atrial fibrillation. Routine use of anti-arrhythmic medication after surgical ablation is not recommended.
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