Abstract 4049: Cardiac Interventions Prior to Surgical Ablation for Atrial Fibrillation, Do Not Negatively Affect Outcomes
Introduction: Surgical ablation is becoming a more frequent approach to restore sinus rhythm. Data suggests that patients referred for surgical ablation frequently had previous interventions and experienced relatively long duration of atrial fibrillation (AF) which presents a significant challenge. The purpose of this prospective study was to determine if patients who had a prior intervention can expect acceptable outcomes following surgical ablation.
Methods: Patients who undergo the Cox Maze procedure for atrial fibrillation (AF) are prospectively followed at 3, 6, 9, 12, 18, 24 months and yearly thereafter. Previous cardiac intervention is defined as any cardiac surgery, pacemaker implantation or catheter ablations prior to surgery.
Results: Since September of 2005, 362 patients underwent surgical ablation with 122 (34%) patients having had at least one intervention (71% prior cardiac, 2% prior pacemaker and 27% ablation). Prior intervention was documented in 30% of the patients presenting for a concomitant cardiac procedure with surgical ablation and in 45% having a stand alone surgical ablation. The pre maze intervention group (PMIG) was significantly older and had a longer duration of AF than the pre maze non intervention group (PMNIG). The was no difference in the return to sinus rhythm between groups for patients who had reached their 6, 12 and 24 month time point post surgical ablation. Post maze procedure, the PMIG group required significantly more cardioversions and ablations to address new onset atrial arrhythmias in order to restore NSR (Table 1⇓).
Conclusion: Patients who present for surgical ablation of their atrial fibrillation with history of prior intervention (cardiac surgery, pacemaker and or catheter ablation) can expect a high rate of return to sinus rhythm as well as a return to sinus rhythm off anti arrhythmic medications. Patients with different types of prior interventions should be considered favorably for surgical ablation.