Safety of Atrial Fibrillation Ablation With Isolated Surgical Aortic Valve Replacement.
Ann Thorac Surg
; 111(3): 809-817, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-32791060
ABSTRACT
BACKGROUND:
Surgical ablation of atrial fibrillation (AF) concomitant with cardiac surgery is a Society of Thoracic Surgeons (STS) class I recommendation, although the AF is frequently ignored. Analysis of the STS Database 30-day outcomes of isolated surgical aortic valve replacement (AVR) with and without AF ablation is presented.METHODS:
Data on 87,426 surgical aortic valve replacement patients were extracted from the STS database (version 2.81, 2014-2017) and patients were divided into 3 groups (1) No preoperative AF, (2) Preoperative AF with concomitant ablation, and (3) Preoperative AF without ablation. The latter 2 groups were propensity score-matched in 1-(up)-to-2 ratio to alleviate covariate imbalances and reduce bias. Thirty-day outcomes were evaluated and compared.RESULTS:
Preoperative AF was present in 17.8% (15,596 of 87,426 patients). Ablation was performed in 33.1% (5,167 of 15,596), and 57.7% (2,983) had left atrial appendage closure. Propensity score matching (AF ablated n = 3692; AF non-ablated n = 5724), revealed that there was no difference between the AF ablated and AF non-ablated groups in mortality (2.8% vs 3.0%, respectively; P = .65) or for stroke (1.6% vs 1.7%, respectively; P = .82), but postoperative pacemaker implantation was higher in the AF ablated patients (6.8% AF ablated vs 5.0% AF non-ablated, P < .001).CONCLUSIONS:
Despite being a class I recommendation, AF ablation concomitantly with other cardiac surgical procedures remains lower than current guideline recommendation in surgical aortic valve replacement patients. Ablation for AF does not increase the 30-day operative mortality or perioperative morbidity compared with non-ablated patients, although new pacemaker requirements were higher in the AF ablated group.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
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Complicações Pós-Operatórias
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Fibrilação Atrial
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Próteses Valvulares Cardíacas
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Implante de Prótese de Valva Cardíaca
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Pontuação de Propensão
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Doenças das Valvas Cardíacas
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article