Int J Angiol 2020; 29(02): 123-130
DOI: 10.1055/s-0040-1705111
Invited Articles
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contemporary Surgical Management of Atrial Fibrillation

Tyler M. Gunn
1   Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky
,
Tessa E. London
1   Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky
,
Sibu P. Saha
1   Division of Cardiothoracic Surgery, University of Kentucky, Lexington, Kentucky
› Author Affiliations
Further Information

Publication History

Publication Date:
29 March 2020 (online)

Abstract

Atrial fibrillation is a common arrhythmia which may cause symptoms that significantly impact quality of life and is associated with increased risk of stroke, heart failure, and sudden death. Over the past three decades many surgical techniques as well as catheter-bases procedures have been developed to treat atrial fibrillation. In this review we describe the indications, treatments, outcomes, surgical techniques, and technical advances reported in the literature.

Conflict of Interest

None.


 
  • References

  • 1 Chen LY, Benditt DG, Alonso A. Atrial fibrillation and its association with sudden cardiac death. Circ J 2014; 78 (11) 2588-2593
  • 2 Miyasaka Y, Barnes ME, Bailey KR. , et al. Mortality trends in patients diagnosed with first atrial fibrillation: a 21-year community-based study. J Am Coll Cardiol 2007; 49 (09) 986-992
  • 3 Calkins H, Hindricks G, Cappato R. , et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm 2017; 14 (10) e275-e444
  • 4 Chugh SS, Havmoeller R, Narayanan K. , et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation 2014; 129 (08) 837-847
  • 5 January CT, Wann LS, Alpert JS. , et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64 (21) e1-e76
  • 6 Hou Y, Zhou Q, Po SS. Neuromodulation for cardiac arrhythmia. Heart Rhythm 2016; 13 (02) 584-592
  • 7 Ruaengsri C, Schill MR, Khiabani AJ, Schuessler RB, Melby SJ, Damiano Jr RJ. The Cox-maze IV procedure in its second decade: still the gold standard?. Eur J Cardiothorac Surg 2018; 53 (01) (Suppl. 01) i19-i25
  • 8 Badhwar V, Rankin JS, Damiano Jr RJ. , et al. The Society of Thoracic Surgeons 2017 clinical practice guidelines for the surgical treatment of atrial fibrillation. Ann Thorac Surg 2017; 103 (01) 329-341
  • 9 Srivastava V, Kumar S, Javali S. , et al. Efficacy of three different ablative procedures to treat atrial fibrillation in patients with valvular heart disease: a randomised trial. Heart Lung Circ 2008; 17 (03) 232-240
  • 10 Davies RA, Kumar S, Chard RB, Thomas SP. Surgical and hybrid ablation of atrial fibrillation. Heart Lung Circ 2017; 26 (09) 960-966
  • 11 Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 1996; 61 (02) 755-759
  • 12 Holmes DR, Reddy VY, Turi ZG. , et al; PROTECT AF Investigators. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 2009; 374 (9689): 534-542
  • 13 Ailawadi G, Gerdisch MW, Harvey RL. , et al. Exclusion of the left atrial appendage with a novel device: early results of a multicenter trial. J Thorac Cardiovasc Surg 2011; 142 (05) 1002-1009 , 1009.e1
  • 14 Emmert MY, Puippe G, Baumüller S. , et al. Safe, effective and durable epicardial left atrial appendage clip occlusion in patients with atrial fibrillation undergoing cardiac surgery: first long-term results from a prospective device trial. Eur J Cardiothorac Surg 2014; 45 (01) 126-131
  • 15 Ad N, Holmes SD, Friehling T. Minimally invasive stand-alone Cox maze procedure for persistent and long-standing persistent atrial fibrillation: perioperative safety and 5-year outcomes. Circ Arrhythm Electrophysiol 2017; 10 (11) e005352
  • 16 Zembala MO, Suwalski P. Minimally invasive surgery for atrial fibrillation. J Thorac Dis 2013; 5 (Suppl. 06) S704-S712
  • 17 van Laar C, Kelder J, van Putte BP. The totally thoracoscopic maze procedure for the treatment of atrial fibrillation. Interact Cardiovasc Thorac Surg 2017; 24 (01) 102-111
  • 18 Geršak B, Zembala MO, Müller D. , et al. European experience of the convergent atrial fibrillation procedure: multicenter outcomes in consecutive patients. J Thorac Cardiovasc Surg 2014; 147 (04) 1411-1416
  • 19 Geršak B, Jan M. Long-term success for the convergent atrial fibrillation procedure: 4-year outcomes. Ann Thorac Surg 2016; 102 (05) 1550-1557
  • 20 Cox JL, Churyla A, Malaisrie SC. , et al. A hybrid maze procedure for long-standing persistent atrial fibrillation. Ann Thorac Surg 2019; 107 (02) 610-618
  • 21 Philpott JM, Zemlin CW, Cox JL. , et al. The ABLATE trial: safety and efficacy of Cox maze-IV using a bipolar radiofrequency ablation system. Ann Thorac Surg 2015; 100 (05) 1541-1546 , discussion 1547–1548
  • 22 Kuck K, Brugada J, Albenque J. Cryoballoon or radiofrequency ablation for atrial fibrillation. N Engl J Med 2016; 375 (11) 1100-1101
  • 23 Scherr D, Dalal D, Chilukuri K. , et al. Incidence and predictors of left atrial thrombus prior to catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2009; 20 (04) 379-384
  • 24 Noseworthy PA, Kapa S, Deshmukh AJ. , et al. Risk of stroke after catheter ablation versus cardioversion for atrial fibrillation: a propensity-matched study of 24,244 patients. Heart Rhythm 2015; 12 (06) 1154-1161
  • 25 Mohanty S, Santangeli P, Mohanty P. , et al. Outcomes of atrioesophageal fistula following catheter ablation of atrial fibrillation treated with surgical repair versus esophageal stenting. J Cardiovasc Electrophysiol 2014; 25 (06) 579-584
  • 26 Witt C, Powell B, Holmes D, Alli O. Recurrent dyspnea following multiple ablations for atrial fibrillation explained by the “stiff left atrial syndrome”. Catheter Cardiovasc Interv 2013; 82 (05) E747-E749
  • 27 Rankin JS, He X, O'Brien SM. , et al. The Society of Thoracic Surgeons risk model for operative mortality after multiple valve surgery. Ann Thorac Surg 2013; 95 (04) 1484-1490
  • 28 Doukas G, Samani NJ, Alexiou C. , et al. Left atrial radiofrequency ablation during mitral valve surgery for continuous atrial fibrillation: a randomized controlled trial. JAMA 2005; 294 (18) 2323-2329
  • 29 Phan K, Xie A, La Meir M, Black D, Yan TD. Surgical ablation for treatment of atrial fibrillation in cardiac surgery: a cumulative meta-analysis of randomised controlled trials. Heart 2014; 100 (09) 722-730
  • 30 Blackstone EH, Chang HL, Rajeswaran J. , et al; Cardiothoracic Surgical Trials Network Investigators. Biatrial maze procedure versus pulmonary vein isolation for atrial fibrillation during mitral valve surgery: new analytical approaches and end points. J Thorac Cardiovasc Surg 2019; 157 (01) 234-243 .e9
  • 31 Damiano Jr RJ, Gaynor SL, Bailey M. , et al. The long-term outcome of patients with coronary disease and atrial fibrillation undergoing the Cox maze procedure. J Thorac Cardiovasc Surg 2003; 126 (06) 2016-2021
  • 32 Cherniavsky A, Kareva Y, Pak I. , et al. Assessment of results of surgical treatment for persistent atrial fibrillation during coronary artery bypass grafting using implantable loop recorders. Interact Cardiovasc Thorac Surg 2014; 18 (06) 727-731
  • 33 Boersma LV, Castella M, van Boven W. , et al. Atrial fibrillation catheter ablation versus surgical ablation treatment (FAST): a 2-center randomized clinical trial. Circulation 2012; 125 (01) 23-30
  • 34 Henn MC, Lancaster TS, Miller JR. , et al. Late outcomes after the Cox maze IV procedure for atrial fibrillation. J Thorac Cardiovasc Surg 2015; 150 (05) 1168-1176 , 1178.e1–1178.e2
  • 35 Roux JF, Zado E, Callans DJ. , et al. Antiarrhythmics after ablation of atrial fibrillation (5A study). Circulation 2009; 120 (12) 1036-1040
  • 36 Koyama T, Tada H, Sekiguchi Y. , et al. Prevention of atrial fibrillation recurrence with corticosteroids after radiofrequency catheter ablation: a randomized controlled trial. J Am Coll Cardiol 2010; 56 (18) 1463-1472
  • 37 Kim YR, Nam GB, Han S. , et al. Effect of short-term steroid therapy on early recurrence during the blanking period after catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol 2015; 8 (06) 1366-1372