Ten-year outcome of intraoperative treatment of atrial fibrillation using radiofrequency ablation
Received 5 March 2017
Accepted for publication 25 August 2017
Published 19 September 2017 Volume 2017:13 Pages 1233—1237
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Nour Boulad,1 Nicolas W Shammas,1 Gerald Early,2 Shauna Roberts,3 Gail A Shammas,1 Yuhning Linda Hu,1 Holly Park,1 Michael Jerin1
1Midwest Cardiovascular Research Foundation, Bettendorf, IA, 2Cardiac and Thoracic Surgery, Pullman Hospital, Pullman, WA, 3Truman Medical Center-Hospital Hill, Kansas City, MO, USA
Background: Intraoperative radiofrequency ablation (RFA) has been advocated to treat atrial fibrillation (AF). This report examines the long-term effects of intraoperative RFA in the prevention of recurrence of AF when used as an adjunctive treatment in patients undergoing cardiac procedures for primary indications unrelated to their arrhythmia.
Methods: The study reviewed the records of patients from a tertiary medical center which had 2 cardiac surgeons performing an intraoperative adjunctive RFA procedure. A total of 20 patients undergoing RFA between April 11, 2003 and May 10, 2005 were included and followed for up to 10 years. The primary effectiveness outcome of the study was the recurrence of AF during the follow-up period. Data were collected from office or hospital medical records.
Results: A total of 20 patients were included (mean age 69.4 years, males 40%). Eight patients were followed for 10 years and 2 patients for 9 years; 7 patients died during the 10-year follow-up period and 3 patients were lost to follow-up. As their primary procedures, the patients underwent valve surgery (65%), bypass surgery (15%), or both (20%). Intraoperative RFA failed to restore sinus rhythm in 2 patients. In the remaining 18 patients, AF recurred in 10 patients within 2 months of surgery, in 1 patient at 5 months, in 1 patient at 7 months, and in 6 patients after 1 year.
Conclusion: AF had recurred in 100% of patients by the end of the long-term follow-up period. The adjunctive intraoperative RFA and postoperative interventions employed in this early study failed to maintain sinus rhythm.
Keywords: radiofrequency ablation, cardiac surgery, intraoperative, long-term outcome