Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and its prevalence is ∼1-2% of the general population, but higher with increasing age and in patients with concomitant heart disease. The Cox-maze III procedure was a groundbreaking development and remains the surgical intervention with the highest cure rate, but due to its technical difficulty alternative techniques have been developed to create the lesions sets. The field is fast moving and there are now multiple energy sources, multiple potential lesion sets and even multiple guidelines addressing the issues surrounding the surgical treatment of AF both for patients undergoing this concomitantly with other cardiac surgical procedures and also as stand-alone procedures either via sternotomy or via videothoracoscopic techniques. The aim of this document is to bring together all major guidelines in this area into one resource for clinicians interested in surgery for AF. Where we felt that guidance was lacking, we also reviewed the evidence and provided summaries in those areas. We conclude that AF surgery is an effective intervention for patients with all types of AF undergoing concomitant cardiac surgery to reduce the incidence of AF, as demonstrated in multiple randomized studies. There is some evidence that this translates into reduced stroke risk, reduced heart failure risk and longer survival. In addition, symptomatic patients with AF may be considered for surgery after failed catheter intervention or even as an alternative to catheter intervention where either catheter ablation is contraindicated or by patient choice.

Dunning, J., Nagendran, M., Alfieri, O., Elia, S., Kappetein, A., Lockowandt, U., et al. (2013). Guideline for the surgical treatment of atrial fibrillation. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 44, 777-791 [10.1093/ejcts/ezt413].

Guideline for the surgical treatment of atrial fibrillation

ELIA, STEFANO;
2013-08-16

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and its prevalence is ∼1-2% of the general population, but higher with increasing age and in patients with concomitant heart disease. The Cox-maze III procedure was a groundbreaking development and remains the surgical intervention with the highest cure rate, but due to its technical difficulty alternative techniques have been developed to create the lesions sets. The field is fast moving and there are now multiple energy sources, multiple potential lesion sets and even multiple guidelines addressing the issues surrounding the surgical treatment of AF both for patients undergoing this concomitantly with other cardiac surgical procedures and also as stand-alone procedures either via sternotomy or via videothoracoscopic techniques. The aim of this document is to bring together all major guidelines in this area into one resource for clinicians interested in surgery for AF. Where we felt that guidance was lacking, we also reviewed the evidence and provided summaries in those areas. We conclude that AF surgery is an effective intervention for patients with all types of AF undergoing concomitant cardiac surgery to reduce the incidence of AF, as demonstrated in multiple randomized studies. There is some evidence that this translates into reduced stroke risk, reduced heart failure risk and longer survival. In addition, symptomatic patients with AF may be considered for surgery after failed catheter intervention or even as an alternative to catheter intervention where either catheter ablation is contraindicated or by patient choice.
16-ago-2013
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/21 - CHIRURGIA TORACICA
English
Con Impact Factor ISI
Cardiac surgery, Guideline,Atrial fibrillation,Ablation,Cox-maze,Maze
Linee guida compilate da un comitato di esperti internazionali
Dunning, J., Nagendran, M., Alfieri, O., Elia, S., Kappetein, A., Lockowandt, U., et al. (2013). Guideline for the surgical treatment of atrial fibrillation. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 44, 777-791 [10.1093/ejcts/ezt413].
Dunning, J; Nagendran, M; Alfieri, O; Elia, S; Kappetein, A; Lockowandt, U; Sarris, G; Kolh, P
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/80868
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