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Europace Advance Access originally published online on March 28, 2008
Europace 2008 10(5):610-617; doi:10.1093/europace/eun066
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

ABLATION FOR ATRIAL FIBRILLATION

Short-term sinus rhythm predicts long-term sinus rhythm and clinical improvement after intraoperative ablation of atrial fibrillation

Birgitta Johansson1,*, Birgitta Houltz3, Eva Berglin2, Gunnar Brandrup-Wognsen2, Thomas Karlsson1 and Nils Edvardsson1

1 Department of Cardiology, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden; 2 Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden; 3 Department of Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden

Aims: Our aim was to compare the long-term effects on rhythm and quality of life (QoL) after left atrial epicardial radiofrequency (RF) ablation vs. no ablation in patients undergoing cardiac surgery.

Methods and results: Thirty-nine patients with ECG documented atrial fibrillation (AF) scheduled for coronary artery bypass grafting (CABG) with or without concomitant valve surgery were consecutively elected for epicardial RF ablation. Thirty-nine age- and gender-matched patients scheduled for CABG with or without concomitant valve surgery only and with documented AF served as controls. The follow-up after ablation was 32 ± 11 months. The percentage of patients in sinus rhythm (SR) at long-term follow-up was 62 vs. 33% (P = 0.03) after ablation and no ablation, respectively. SR at 3 months was highly predictive of that at 32 months (sensitivity 95%, positive predictive value 86%). Long-term SR was associated with better QoL, fewer symptoms, higher ejection fraction, and smaller left and right atria than AF.

Conclusion: SR at 3 months was highly predictive of long-term SR that was associated with clinical improvement when compared with patients still in AF. AF at 3 months did not preclude a later stabilization to SR.

Key Words: Ablation, Atrial fibrillation, CABG, Quality of life

* Corresponding author. Tel: +46 31 342 75 52; fax: +46 31 82 32 41.E-mail address: birgitta.ingrid.johansson{at}vgregion.se

Manuscript submitted 24 November 2007. Accepted after revision 28 February 2008.


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