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Predicting success of concomitant surgical ablation in persistent atrial fibrillation
Session:
Sessão de Posters 38 - Encerramento estrutural e desfechos cirúrgicos: do PFO ao bloco operatório
Speaker:
David Vicente Marques
Congress:
CPC 2026
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.9 Cardiovascular Surgery – Arrhythmias
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
David Vicente Marques; Mariana Caetano Coelho; Sofia Delgado; Rui Cerejo; Guilherme Portugal; Ana Lousinha; Bruno Valente; Pedro Silva Cunha; Hagen Kahlbau; Rui Rodrigues; Pedro Coelho; Mário Oliveira
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black"><strong>Abstract: </strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black">Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, frequently associated with cardiac conditions with indication for surgical intervention. AF ablation is the best option for long term rhythm control. Surgical AF ablation may be considered in patients (P) who undergo cardiac surgery. However, concomitant AF ablation is still underperformed in AF P submitted to cardiac surgery.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black"><strong>Methods:</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black">The sample included 49 P (67.0<span style="font-family:"Arial Unicode MS",serif">±</span>9.6 years, 57.1% male) who underwent surgical AF ablation (2020–2024) concomitant with elective cardiac surgery. A retrospective single-center analysis was performed, with two groups regarding the heart rhythm during median-term follow-up (sinus rhythm – SR - vs AF recurrence). The mean follow-up was 469 days (+/- 382 days). Demographic, perioperative and echocardiographic variables and type of surgery were extracted. Variables were compared with Mann-Whitney U or Fisher<span style="font-family:"Arial Unicode MS",serif">’</span>s exact test, as appropriate. Odds ratios (OR) with 95% CI were calculated.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black"><strong>Results:</strong><br /> There were 26 P (53.1%) in SR and 47,9% recurrences of atrial arrhytmias (AF - 20, AT/AFL - 3) at the last point of follow-up. There were no significant differences found in echocardiographic features. SR at 1 month after surgery was significantly associated with SR maintenance at 1 year (OR 7.09; 95%CI; p=0.006) and at the end of follow-up visit the same number of P. In our analysis, the use of cryotherapy compared to radiofrequency showed statistical significance in sustained SR at 1 year follow up, with 3.7 times more likelihood of outcome achievement (CI95% 1.06–12.87; p=0.045 ). Table 1 shows comparative demographics for both these groups. Pulmonary veins isolation or “MAZE” technique did not show statistical significance in achieving SR maintenance.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black"><strong>Conclusions:</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black">Concomitant AF ablation during cardiac surgery can be an effective option for maintaining SR. Cryotherapy was associated with significantly higher rates of sustained SR at 1-year follow-up. Moreover, early post-operative rhythm was strongly predictive of long-term success, suggesting that early heart rhythm assessment may help identifying patients who need close follow-up and further interventions.</span></span></span></p>
Slides
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