Outcomes of Surgical Ablation in Patients With Atrial Fibrillation Undergoing Cardiac Surgeries

Ayman Elbadawi; Islam Y. Elgendy; Ahmed H. Mahmoud; Gbolahan O. Ogunbayo; Marwan Saad; Michael Megaly; Erfan Alotaki; Amgad Mentias; Amr F. Barakat; Barry London

doi:10.1016/j.athoracsur.2018.10.040

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Outcomes of Surgical Ablation in Patients With Atrial Fibrillation Undergoing Cardiac Surgeries

Journal article

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Outcomes of Surgical Ablation in Patients With Atrial Fibrillation Undergoing Cardiac Surgeries

Ayman Elbadawi, Islam Y. Elgendy, Ahmed H. Mahmoud, Gbolahan O. Ogunbayo, Marwan Saad, Michael Megaly, Erfan Alotaki, Amgad Mentias, Amr F. Barakat and Barry London

The Annals of thoracic surgery, Vol.107(5), pp.1395-1400

05/01/2019

DOI: 10.1016/j.athoracsur.2018.10.040

PMID: 30481521

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Abstract

Background. Surgical ablation procedure is commonly performed in patients with atrial fibrillation (AF) undergoing cardiac surgeries; however, the evidence regarding its impact on in-hospital cardiovascular outcomes is controversial. Methods. We queried the Nationwide Inpatient Sample Database for patients with AF who underwent cardiac surgeries from 1998 to 2013. We performed a propensity-score matching including 21 various baseline characteristics to compare those who underwent surgical ablation with those who had not. Results. A total of 47,964 hospitalizations were included in our final analysis. On propensity matching, 23,975 were in the surgical ablation group and 23,990 in the control group. The primary outcome of in-hospital mortality was lower in the surgical ablation group compared with the control group (3.6% versus 4.2%, p < 0.001). The surgical ablation group was associated with lower in-hospital cerebrovascular accident (2.0% versus 2.8%, p < 0.001), cardiogenic shock (2.6% versus 3.6%, p < 0.001), use of intraaortic balloon pump (5.1% versus 5.8%, p = 0.001), and shorter length of hospital stay (12.3 +/- 10.1 versus 12.5 +/- 10.3 days, p = 0.008). There was no difference between the surgical ablation and control groups in the incidence of cardiac tamponade (0.4% versus 0.3%, p = 0.296). The surgical ablation group was associated with a higher rate of complete heart block (5.2% versus 4.3%, p < 0.001) and permanent pacemaker insertion (8.6% versus 8.0%, p = 0.01). Conclusions. In this large analysis of almost 50,000 patients with AF undergoing cardiac surgery, surgical ablation appears to be safe in the short term. Future studies should focus on evaluating the long-term effectiveness of this procedure. (C) 2019 by The Society of Thoracic Surgeons

Cardiac & Cardiovascular Systems

Cardiovascular System & Cardiology

Life Sciences & Biomedicine

Respiratory System

Science & Technology

Surgery

Details

Title: Subtitle: Outcomes of Surgical Ablation in Patients With Atrial Fibrillation Undergoing Cardiac Surgeries
Creators: Ayman Elbadawi - Ain Shams University Faculty of Medicine
Islam Y. Elgendy - University of Florida
Ahmed H. Mahmoud - Department of Internal Medicine, Rochester General Hospital, Rochester, New York
Gbolahan O. Ogunbayo - University of Kentucky
Marwan Saad - Ain Shams University Faculty of Medicine
Michael Megaly - Abbott Northwestern Hospital
Erfan Alotaki - Department of Internal Medicine, Rochester General Hospital, Rochester, New York
Amgad Mentias - University of Iowa
Amr F. Barakat - University of Pittsburgh
Barry London - University of Iowa
Resource Type: Journal article
Publication Details: The Annals of thoracic surgery, Vol.107(5), pp.1395-1400
DOI: 10.1016/j.athoracsur.2018.10.040
PMID: 30481521
NLM abbreviation: Ann Thorac Surg
ISSN: 0003-4975
eISSN: 1552-6259
Publisher: Elsevier
Number of pages: 6
Language: English
Date published: 05/01/2019
Academic Unit: Molecular Physiology and Biophysics; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984297497602771

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