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A 5-year clinical experience with bipolar radiofrequency ablation for permanent atrial fibrillation concomitant to coronary artery bypass grafting and aortic valve surgery

Hanseatisches Herzzentrum, Abteilung für Herzchirurgie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany

*Corresponding author. Tel.: +49 40 181885 4150; fax: +49 40 181885 4184.

E-mail address: s.geidel{at}asklepios.com, StGeidel{at}aol.com (S. Geidel).

This study analyses the 5-year results of permanent atrial fibrillation (pAF) bipolar radiofrequency (RF) ablation surgery concomitant to coronary artery bypass grafting (CABG) and/or aortic valve (AV) surgery. Eighty-five patients with pAF (0.5–30 years) underwent bipolar RF ablation procedure concomitant to CABG/AV surgery. All patients were restudied to assess survival, conversion rate to stable sinus rhythm (SR) and New York Heart Association (NYHA) class at 8±1 days and at 3±1 and 32±15 months after surgery. Survival at time of re-examination was 100%, 98% and 96%, respectively (three non-cardiac deaths), SR could be documented in 61%, 74% and 78% of patients. Long-term AF before surgery and larger size of the left atrium (LA) were predictive for postoperative AF return (P=0.005, P=0.03); 88% of patients with small preoperative LA-size (<50 mm) and 85% with pAF-duration time <5 years had stable SR at late follow-up. Cardiac rhythm at three months was predictive for long-term rhythm-prognosis (P<0.0001). NYHA-class improved significantly after surgery (P<0.0005), particularly when SR was achieved (P=0.046). Permanent AF bipolar RF ablation surgery revealed excellent results in AV/CABG patients. It could be demonstrated that established SR remained stable over time. Preoperative pAF-duration time and LA-size are useful variables to predict the success rate of ablation.

Key Words: Aortic valve surgery; Arrhythmia surgery; Atrial fibrillation; Bipolar radiofrequency ablation; Coronary artery bypass grafting; Radiofrequency ablation