Open AccessShort-term outcomes of surgical atrial ablation and septal myectomy
Author(s) -
Anton Zalesov,
Alexander V. BogachevProkophiev,
Alexander Afanasyev,
Ravil Sharifulin,
Andrey Sapegin,
Sergei A. Budagaev,
С. И. Железнев,
И. И. Демин
Publication year - 2021
Publication title -
patologiâ krovoobraŝeniâ i kardiohirurgiâ/patologiâ krovoobrašeniâ i kardiohirurgiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.136
H-Index - 3
eISSN - 2500-3119
pISSN - 1681-3472
DOI - 10.21688/1681-3472-2021-3-51-60
Subject(s) - medicine , cardiology , atrial fibrillation , septal myectomy , sinus rhythm , concomitant , hypertrophic cardiomyopathy , cardiomyopathy , ablation , radiofrequency ablation , surgery , obstructive cardiomyopathy , heart failure
Background. Hypertrophic cardiomyopathy is one of the most common types of cardiomyopathy. The appearance of atrial fibrillation in patients with hypertrophic obstructive cardiomyopathy is associated with significant clinical worsening. Outcomes of surgical ablation and septal myectomy in these patients are limited. Aim. This retrospective study aimed to evaluate short-term outcomes of concomitant surgical ablation and septal myectomy in patients with obstructive hypertrophic cardiomyopathy and atrial fibrillation. Methods. Fifty-five patients with hypertrophic obstructive cardiomyopathy and atrial fibrillation who underwent concomitant surgical ablation and septal myectomy between 2014 and 2019 were analysed. Patients with paroxysmal atrial fibrillation predominantly underwent left atrial ablation, and those with nonparoxysmal atrial fibrillation predominantly underwent the Maze IV procedure. Surgical ablation was performed using cryoablation alone (83.6%) or in combination with radiofrequency energy (16.4%). Results. Hospital mortality was 1.8%. Incidence of major adverse events was 3.6%. Sinus node dysfunction and atrioventricular block occurred in 7.3% and 1.8% of patients, respectively. Bleeding requiring revision occurred in 2 (3.6%) patients. Forty-nine (89.1%) patients had stable sinus rhythm and five (9.1%) were on dual-chamber pacemaker stimulation at the time of discharge. Conclusion. Concomitant septal myectomy and surgical ablation are feasible and safe in patients with hypertrophic obstructive cardiomyopathy and atrial fibrillation. Received 5 April 2021. Revised 16 May 2021. Accepted 17 May 2021. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflicts of interests. Contribution of the authors Conception and study design: A.S. Zalesov, A.V. Bogachev-Prokophiev Data collection and analysis: A.S. Zalesov, S.A. Budagaev, A.V. Sapegin Statistical analysis: A.S. Zalesov, A.V. Afanasyev, R.M. Sharifulin Drafting the article: A.S. Zalesov Critical revision of the article: A.V. Bogachev-Prokophiev, S.I. Zheleznev, I.I. Demin Final approval of the version to be published: A.S. Zalesov, A.V. Bogachev-Prokophiev, A.V. Afanasyev, R.M. Sharifulin, A.V. Sapegin, S.A. Budagaev, S.I. Zheleznev, I.I. Demin