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Atrial fibrillation: Current and emerging surgical strategies
Author(s) -
Hassanabad Ali Fatehi,
Jefferson Hallie L.,
Shanmugam Ganesh,
Kent William D T
Publication year - 2019
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/jocs.14194
Subject(s) - medicine , atrial fibrillation , catheter ablation , intensive care medicine , management of atrial fibrillation , surgical procedures , review article , stroke (engine) , surgery , general surgery , cardiology , pathology , mechanical engineering , engineering
Objective (a) To provide a comprehensive review of current literature on the surgical management of atrial fibrillation (AF), highlighting surgical approaches and outcomes. (b) To summarize the latest guidelines pertinent to the surgical management of AF. Background AF is associated with high rates of morbidity and mortality, primarily related to the associated risk of stroke. The mainstay of management is pharmacologic rate or rhythm control and catheter‐based ablation. Surgical ablation (SA) is an alternative strategy that is effective in select patient populations. Recently, novel techniques and technologies have been introduced and this has expanded the surgical capacity to manage AF. Methods A comprehensive review of the literature was conducted. Results Surgery can be a highly effective alternative therapeutic option for the management of AF in the appropriate patient population. The need for permanent pacemaker implantation is controversial among patients undergoing surgical intervention for AF. Surgical outcomes are promising, with long‐term control of AF and symptomatic relief achieved in select groups of patients. Conclusions This article provides a comprehensive review of the surgical management of AF. We have summarized the latest surgical outcomes and contextualized the most recent guidelines.