scholarly journals Long-Term Survival Following Surgical Ablation for Atrial Fibrillation Concomitant to Isolated and Combined Coronary Artery Bypass Surgery—Analysis from the Polish National Registry of Cardiac Surgery Procedures (KROK)

2020 ◽  
Vol 9 (5) ◽  
pp. 1345
Author(s):  
Mariusz Kowalewski ◽  
Marek Jasiński ◽  
Jakub Staromłyński ◽  
Marian Zembala ◽  
Kazimierz Widenka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
National Registry ◽  
Surgical Ablation ◽  
Term Survival ◽  
Long Term Survival

The current investigation aimed to evaluate long-term survival in patients undergoing isolated and combined coronary artery bypass grafting (CABG) with concomitant surgical ablation for atrial fibrillation (AF). Procedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were retrospectively collected. Eleven thousand three hundred sixteen patients with baseline AF (72.4% men, mean age 69.6 ± 7.9) undergoing isolated and combined CABG surgery between 2006–2019 in 37 reference centers across Poland and included in the registry were analyzed. The median follow-up was four years (3.7 IQR 1.3–6.8). Over a 12-year study period, there was a significant survival benefit (Hazard Ratio (HR) 0.83; (95% Confidence Interval (CI): 0.73–0.95); p = 0.005) with concomitant ablation as compared to no concomitant ablation. After rigorous propensity matching (LOGIT model, 432 pairs), concomitant surgical ablation was associated with over 25% improved survival in the overall analysis: HR 0.74; (95% CIs: 0.56–0.98); p = 0.036. The benefit of concomitant ablation was maintained in the subgroups, yet the most benefit was appraised in low-risk patients (EuroSCORE < 2, p = 0.003) with the three-vessel disease (p < 0.001) and without other comorbidities. Ablation was further associated with significantly improved survival in patients undergoing CABG with mitral valve surgery (HR 0.62; (95% CIs: 0.52–0.74); p < 0.001) and in patients in whom complete revascularization was not achieved: HR 0.43; (95% CIs: 0.24–0.79); p = 0.006.

scholarly journals Surgical ablation for atrial fibrillation during isolated coronary artery bypass surgery

2019 ◽  
Author(s):  
Piotr Suwalski ◽  
Mariusz Kowalewski ◽  
Marek Jasiński ◽  
Jakub Staromłyński ◽  
Marian Zembala ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Risk Ratio ◽  
Artery Bypass ◽  
Left Ventricular ◽  
Surgical Ablation ◽  
Term Survival ◽  
Long Term Survival

Abstract OBJECTIVES Our goal was to evaluate early sequelae and long-term survival in patients undergoing isolated coronary artery bypass grafting (CABG) with concomitant surgical ablation for atrial fibrillation (AF). METHODS Procedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were collected. A total of 7879 patients with underlying AF underwent isolated CABG between 2006 and 2018 in 37 reference centres across Poland. The mean follow-up was 4.7 ± 3.5 years [median (interquartile range) 4.3 (1.7–7.4)]. Propensity score matching and Cox proportional hazards models were used to compare isolated CABG + ablation with isolated CABG. RESULTS Of the included patients, 346 (4.39%) underwent surgical ablation. Patients in this group were significantly younger (66.4 ± 7.5 vs 69.2 ± 8.2; P < 0.001) but had a non-significant, different baseline surgical risk (EuroSCORE: 2.11 vs 2.50; P = 0.088). After a rigorous 1:3 propensity matching (LOGIT model: 306 cases of isolated CABG + ablation vs 918 of isolated CABG alone), surgical ablation was associated with a lower 30-day risk of death [risk ratio 0.37, 95% confidence interval (CI) 0.15–0.91; P = 0.032] and multiorgan failure (risk ratio 0.29, 95% CI 0.10–0.94; P = 0.029). In the long term, surgical ablation was associated with a significant 33% improved overall survival rate: hazard ratio 0.67, 95% CI 0.49–0.90; P = 0.008. The benefit of ablation was sustained in the subgroups but was most pronounced in lower risk older patients (age >70 years, P = 0.020; elective status, P = 0.011) with 3-vessel disease (P = 0.036), history of a cerebrovascular accident (P = 0.018) and preserved left ventricular function [left ventricular ejection fraction >50%; P = 0.017; no signs of heart failure (per New York Heart Association functional class); P = 0.001] and those undergoing on-pump CABG (P < 0.001). CONCLUSION Surgical ablation for AF in patients undergoing isolated CABG is safe and associated with significantly improved long-term survival.

scholarly journals Atrial fibrillation in patients with coronary heart disease: current state of the problem

2021 ◽  
Vol 12 (4) ◽  
pp. 66-74
Author(s):  
Aleksandr S. Zotov ◽  
Emil R. Sakharov ◽  
Sergey V. Korolev ◽  
Olga V. Drakina ◽  
Robert I. Khabazov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Postoperative Mortality ◽  
Surgical Ablation ◽  
Term Survival ◽  
Mortality And Morbidity

Atrial fibrillation is one of the most common types of cardiac arrhythmia observed in clinical practice. Despite advances in the diagnosis and treatment, atrial fibrillation remains one of the leading causes of cardiovascular mortality and morbidity. In addition, atrial fibrillation is quite often combined with other pathologies of the cardiovascular system and is a marker of an unfavorable outcome. Several previous studies have demonstrated reduced survival in patients with coronary artery disease and atrial fibrillation who have not undergone surgery for arrhythmia. According to other data, the presence of preoperative atrial fibrillation among patients undergoing isolated coronary artery bypass grafting was associated with significantly higher rates of major postoperative complications. Nowadays, no one doubts the fact that atrial fibrillation during a coronary artery bypass surgery is a risk factor for increased hospital mortality, postoperative morbidity and leads to a decrease in the long-term survival. The studies confirm the necessity of surgical ablation for atrial fibrillation during coronary revascularization to reduce both short-term and long-term postoperative mortality and late complications.

scholarly journals Incidence, Predictors, and Impact of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Military Veterans

2016 ◽  
Vol 43 (5) ◽  
pp. 397-403 ◽  
Author(s):  
Shuab Omer ◽  
Lorraine D. Cornwell ◽  
Ankur Bakshi ◽  
Eric Rachlin ◽  
Ourania Preventza ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Military Veterans ◽  
Survival Rates ◽  
Postoperative Atrial Fibrillation ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival

Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013. Multivariable logistic regression identified predictors of postoperative atrial fibrillation. Kaplan-Meier analysis was used to evaluate long-term survival (the primary outcome measure), morbidity, and length of hospital stay. Postoperative atrial fibrillation occurred in 215 patients (17.2%). Independent predictors of this sequela were age ≥65 years (odds ratios [95% confidence intervals], 1.7 [1.3–2.4] for patients of age 65–75 yr and 2.6 [1.4–4.8] for patients &gt;75 yr) and body mass index ≥30 kg/m2 (2.0 [1.2–3.2]). Length of stay was longer for patients with postoperative atrial fibrillation than for those without (12.7 ± 6.6 vs 10.3 ± 8.9 d; P ≤0.0001), and the respective 30-day mortality rate was higher (1.9% vs 0.4%; P=0.014). Seven-year survival rates did not differ significantly. Older and obese patients are particularly at risk of postoperative atrial fibrillation after CABG. Patients who develop the sequela have longer hospital stays than, but similar long-term survival rates to, patients who do not.

scholarly journals Predicting long-term survival after coronary artery bypass graft surgery

2017 ◽  
Vol 26 (2) ◽  
pp. 257-263 ◽  
Author(s):  
Md N Karim ◽  
Christopher M Reid ◽  
Molla Huq ◽  
Samuel L Brilleman ◽  
Andrew Cochrane ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Term Survival ◽  
Long Term Survival

Transfusion in Coronary Artery Bypass Grafting is Associated with Reduced Long-Term Survival

2006 ◽  
Vol 81 (5) ◽  
pp. 1650-1657 ◽  
Author(s):  
Colleen Gorman Koch ◽  
Liang Li ◽  
Andra I. Duncan ◽  
Tomislav Mihaljevic ◽  
Floyd D. Loop ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival ◽  
Artery Bypass Grafting

scholarly journals Long-term survival after coronary artery bypass surgery stratified by EuroSCORE

2012 ◽  
Vol 42 (1) ◽  
pp. 101-107 ◽  
Author(s):  
F. O'Boyle ◽  
N. Mediratta ◽  
B. Fabri ◽  
M. Pullan ◽  
J. Chalmers ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Term Survival ◽  
Long Term Survival

The Effect of Preoperative β-Blocker Use and Race on Long-Term Survival After Coronary Artery Bypass Grafting

2014 ◽  
Vol 28 (3) ◽  
pp. 595-600 ◽  
Author(s):  
Wesley T. O’Neal ◽  
Jimmy T. Efird ◽  
Hope Landrine ◽  
Curtis A. Anderson ◽  
Stephen W. Davies ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Term Survival ◽  
Long Term Survival ◽  
Artery Bypass Grafting ◽  
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