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Concomitant Ablation of Atrial Fibrillation: Are Results Associated With Surgeon's Experience?
Author(s) -
Grubitzsch Herko,
Beholz Sven,
Dohmen Pascal M.,
Dushe Simon,
Liu Jianshi,
Konertz Wolfgang
Publication year - 2007
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2007.00411.x
Subject(s) - medicine , concomitant , atrial fibrillation , ablation , cardiology , surgery
Background and aim of the study: Atrial fibrillation (AF) ablation has become an effective concomitant procedure, which is increasingly used. We questioned whether results are related to surgeon's experience. Methods: Patients (n = 141) with persistent AF (pAF) underwent concomitant left atrial (LA) endocardial ablation, performed by six surgeons. Follow‐up (FU) was after 3, 6, and 12 months (mean 8 ± 4.1 months). FU was 97% complete. Results were analyzed according to surgeon's volume: >20 (group A, n = 85) and ≤20 (group B, n = 56) ablations per year. Results: Baseline data of groups A and B were similar regarding age (70 ± 9.0 vs. 70 ± 8.1 years, n.s.), NYHA class (3.0 ± 0.84 vs. 2.9 ± 0.95, n.s.), AF duration (58 ± 83.4 vs. 63 ± 69.4 months, n.s.), LA diameter (50 ± 8.5 vs. 48 ± 7.3 mm, n.s.), and LVEF (50 ± 12.0 vs. 50 ± 13.0%, n.s.). Overall mortality (30 days) was 7.1% (six and four in groups A and B, n.s.). Ablation caused no injury or death. At FU sinus rhythm (SR) conversion rate was 68.1% in each group. Atrial contraction was demonstrated in 86.0 and 90.3% of SR patients in groups A and B (n.s.). NYHA functional class improved and was similar in both groups (A: 2.1 ± 0.56, B: 2.1 ± 0.48, n.s.). Compared to non‐SR, SR was associated with better NYHA class (A: 2.0 ± 0.57 vs. 2.3 ± 0.46, p < 0.05; B: 2.0 ± 0.44 vs. 2.3 ± 0.47, p < 0.05) and smaller LA diameter (A: 42 ± 5.5 vs. 46 ± 8.4 mm, p < 0.05; B: 40 ± 5.5 vs. 45 ± 5.8 mm, p < 0.05). Conclusions: We found no association between surgeon's experience and results of AF ablation, neither in SR conversion rate nor in morbidity and mortality.