Michael Knaut1, T. Link1, Friedrich Jung2, Stefan Brose1, Klaus Matschke1
1Department of Cardiac Surgery, University of Technology Dresden, Germany; 2Institute of Clinical Haemostaseology and Transfusion Medicine, University Hospitals of Saarland, Homburg, Germany
[Applied Cardiopulmonary Pathophysiology 16: 17-31, 2012]
Atrial fibrillation not only impairs the quality of life but is also associated with higher mortality and morbidity caused by embolic events or therapeutic anticoagulation treatment. The present prospective registry study evaluated the conversion rates and the influencing factors on outcomes of mitral valve surgery and concomitant microwave ablation in 191 patients with permanent atrial fibrillation.
In approximately 60% of the patients it was possible to establish stable sinus rhythm during the postoperative period whereas, conversion rates between 4% and 33.5% have been reported after cardiac surgery alone without additional surgical ablation therapy. Significant influencing factors on postoperative sinus rhythm were the presence of diabetes mellitus or a history of myocardial infarction, the preoperative atrial size, and tendentially, operation time. There were no ablation-related complications. During the 1.5-year follow-up it became evident that longer operation time (in most cases due to operative complexity with higher risk) and postoperative recurrence of atrial fibrillation were significant factors influencing mortality.
Key words: atrial fibrillation, surgical ablation, mitral valve surgery
Michael Knaut, M.D., Ph.D.
Department of Cardiac Surgery
University of Technology Dresden