@article{ACS17086,
author = {Ashley R. Wilson-Smith and Christian J. Wilson-Smith and Jemilla Strode Smith and Dominic Ng and Benjamin T. Muston and Aditya Eranki and Michael L. Williams and Nathan Ussher and Aashray K. Gupta},
title = {The outcomes of concomitant catheter ablation in non-mitral valve cardiac surgery—a systematic review and meta-analysis of the literature},
journal = {Annals of Cardiothoracic Surgery},
volume = {13},
number = {2},
year = {2024},
keywords = {},
abstract = {Background: Atrial fibrillation (AF) is the most common form of cardiac arrythmia, with a key importance in the perioperative setting of cardiac surgery. In recent years, the question as to whether pre-existent AF should be treated concomitantly when undergoing cardiac surgery has been heatedly debated. This systematic review and meta-analysis sought to delineate the outcomes of patients undergoing concomitant AF ablation procedures alongside cardiac surgery.
Methods: The methods for this systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Four databases were searched, ultimately yielding 22 papers for inclusion, using appropriate search terminology. Meta-analysis using proportions or means, as appropriate, were applied. Kaplan-Meier curves were digitized and aggregated using previously reported and validated techniques.
Results: A total of 9,428 patients (67% male) were identified across the study period as having received non-mitral cardiac surgery and concomitant AF ablation procedures. On actuarial assessment, freedom from AF was found to be 93%, 88%, 85%, 82%, and 79% at 1 through to 5 years, respectively. Freedom from mortality was found to be 94%, 93%, 91%, 90%, and 87% at 1 through to 5 years, respectively.
Conclusions: This review demonstrated excellent freedom from AF out to a long-term follow-up of 5 years. Freedom from mortality was also encouraging. Emerging data are increasingly illustrating that in this patient cohort, concurrent treatment of pre-existent AF with cardiac and/or valvular disease at the point of operation should be the standard of care. Robust data in the form of randomized control trials will hopefully solidify this assertion.},
issn = {2304-1021}, url = {https://www.annalscts.com/article/view/17086}
}