Impact of concomitant surgical atrial fibrillation ablation in patients undergoing aortic valve replacement.
- Title
- Impact of concomitant surgical atrial fibrillation ablation in patients undergoing aortic valve replacement.
- Author
- 노선균
- Keywords
- Aortic valve replacement; Atrial fibrillation; Maze procedure
- Issue Date
- 2014-03
- Publisher
- Nihon Junkanki Gakkai.
- Citation
- Circulation journal : official journal of the Japanese Circulation Society, v.78 no.6[2014년], pp.1364 - 1371
- Abstract
- Background:?The clinical benefit of concomitant atrial fibrillation (AF) ablation at the time of aortic valve replacement (AVR) is uncertain. Methods and Results:?A total of 124 patients with AF who underwent AVR with (n=50) or without (n=74) a concomitant maze procedure, between 2000 and 2011, were evaluated. There were no significant differences in early postoperative outcomes. During a median clinical follow-up of 18.1 months (interquartile range: 6.9?47.8 months), 19 late deaths (15.3%) and 33 valve-related complications (26.6%) occurred, but the differences between groups were not statistically significant. Major event-free survival at 5 years was 60.9±9.9% vs. 57.0±10.3% (P=0.41). After adjustment, the maze group demonstrated similar risks for major adverse cardiac events (hazard ratio, 1.18; 95% confidence interval, 0.56?2.49; P=0.67). However, the rate of sinus rhythm restoration at 4 years was significantly higher in the maze group (80.6% vs. 3.6%, P<0.001). Left atrial dimension was smaller (46.9 vs. 50.4mm, P=0.017), and the ejection fraction was higher (60.6% vs. 58.0%, P=0.059) in the maze group. The rate of postoperative anticoagulation was also lower in the maze group (53.1% vs. 89.2%, P<0.001). Conclusions:?Concomitant AF ablation in patients undergoing AVR resulted in increased sinus rhythm restoration, better echocardiographic results, and decreased anticoagulation requirement, without increasing surgical morbidity or mortality.??(Circ J?2014; 78: 1364?1371)
- URI
- https://www.jstage.jst.go.jp/article/circj/78/6/78_CJ-13-1533/_article/-char/enhttp://hdl.handle.net/20.500.11754/48590
- ISSN
- 1346-9843; 1347-4820
- DOI
- 10.1253/circj.CJ-13-1533
- Appears in Collections:
- COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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