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Heart Rhythm Early After Surgical Ablation of Atrial Fibrillation
Leonid Sternik, Alexander Kogan, David Luria, Michael Glikson, Ateret Malachy, Shany Levin, Ehud Raanani.,
Sheba Medical Center, Ramat-Gan, Israel.

OBJECTIVE: CWhile surgical ablation of atrial fibrillation (AF) is currently a well established procedure, several issues remain unsolved; one of them is a heart rhythm during the first days after the procedure.
METHODS: Between February 2004 and December 2009 we performed AF ablation using the same technique with a bipolar radiofrequency ablator and cryoprobe as part of other cardiac interventional procedures in 212 patients. Of them, 88 patients were in sinus rhythm and 60 in nodal rhythm during the first 3 days post surgery. Patients in both groups were 6311 years of age; of them, 79 (39%) had permanent and 86 (42%) persistent AF, and 25 (14%) had left atrial volume >200 cc. Mitral valve surgery was performed in 75%, left atrial ablation in 79% and biatrial ablation in 21% of patients.
RESULTS: Mean follow-up, performed by electrophysiologists and surgeons, was 39 months (range 26-70 months). . Type and length of AF before surgery, left atrial size and left ventricle function were the same in both groups. . However, patients with nodal rhythm were older (p=0.002) and in lower functional class (p=0.044). At 6 months, 1, 3 and 5 years after ablation there was no statistical difference between groups in ablation results concerning sinus rhythm, antiarrhythmic drug use and anticoagulation.
CONCLUSIONS: While patients in nodal compared with those in sinus rhythm during the first 3 days after ablation were older and had lower functional class, sinus rhythm, antiarrhythmic drug use and anticoagulation results were similar in both groups.


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