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Preoperative Non-Invasive Mapping for Targeted Concomitant Surgical Ablation of Non-Paroxysmal Atrial Fibrillation
David Santer1,2,3, Brigitta Gahl1, Ali Dogan1
1Department of Cardiac Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Journal of Clinical Medicine
|January 25, 2025
Summary
Non-invasive phase mapping (NIPM) guided concomitant surgical ablation (CSA) shows high effectiveness in treating atrial fibrillation (AF). This approach personalizes treatment, increasing patient eligibility for AF ablation.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia requiring effective treatment.
- Concomitant surgical ablation (CSA) is an option for AF patients undergoing cardiac surgery.
- Optimizing CSA strategies is crucial for improving patient outcomes.
Purpose of the Study:
- To introduce and evaluate a targeted approach for CSA using non-invasive phase mapping (NIPM).
- To assess the effectiveness of NIPM-guided CSA in achieving freedom from AF.
- To compare outcomes of NIPM-guided CSA with standard CSA.
Main Methods:
- Retrospective study of cardiac surgical patients undergoing NIPM for CSA guidance.
- Primary outcome: freedom from AF at six months post-surgery.
- Secondary outcomes included AF recurrence, ablation extent, feasibility, and safety.
Main Results:
- NIPM-guided CSA achieved 93% effective ablation frequency.
- The NIPM group showed more extensive biatrial ablation (54% vs. 26%).
- NIPM group patients were younger with lower EuroSCORE II and smaller left atrial size.
Conclusions:
- Routine preoperative NIPM can enhance patient selection for CSA.
- NIPM facilitates a personalized approach to concomitant surgical ablation.
- This strategy may increase the number of patients benefiting from AF surgical treatment.
