ArticleJournal of chest surgery2025
Concomitant Ablation of Atrial Fibrillation in Redo Heart Valve Surgery.
Article in Journal of chest surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background: Although there is general agreement on performing concomitant ablation of atrial fibrillation (AF) during left-sided heart valve surgery in low-risk patients due to its proven long-term clinical benefits, its role in reoperative cases remains debated because of perceived high risks. Methods: This study included 338 consecutive patients with AF who underwent redo surgery for left-sided valve disease between 2000 and 2015 at 2 tertiary referral centers. Among them, 143 patients underwent concomitant surgical ablation for AF (ablation group), while 195 did not (no-ablation group). To evaluate comparative long-term clinical outcomes between the 2 groups, inverse probability of treatment weighting was applied. Results: Early mortality rates were 3.5% (4/143) in the ablation group and 9.2% (18/195) in the no-ablation group (p=0.064). At 5 years, the cumulative incidence of AF recurrence was 12.3%±0.1% in the ablation group and 85.2%±0.1% in the no-ablation group (p<0.001). During follow-up (median, 103 months), the ablation group demonstrated significantly lower risks of death (adjusted hazard ratio [aHR], 0.495; 95% confidence interval [CI], 0.312-0.784; p=0.003) and thromboembolic events (aHR, 0.212; 95% CI, 0.058-0.771; p=0.019) compared with the no-ablation group. Conclusions: Concomitant AF ablation during redo valve surgery was associated with improved rhythm outcomes, survival, and freedom from thromboembolic events, supporting its consideration as a reasonable option even in this high-risk group.
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