Atrial fibrillation correction surgery: lessons from the Society of Thoracic Surgeons National Cardiac Database
Abstract
Background We used The Society of Thoracic Surgeons National Cardiac Database to document the utilization of surgical atrial fibrillation (AF) correction procedures in North America. We also examined the subset of patients having mitral valve surgery to determine whether concurrent surgical AF correction procedures were associated with an increased risk of morbidity or mortality.Methods Retrospective review of outcomes for 67,389 patients with AF having cardiac surgery between January 2004 and December 2006 was conducted. Multivariable logistic regression was performed to assess whether concomitant AF correction procedures increased risk in the mitral valve surgery cohort.Results Overall, 38% (25,718 of 67,389) of patients with AF undergoing cardiac surgery had an AF correction procedure, increasing from 28.1% in 2004 to 40.2% in 2006. Surgical AF correction was performed in 52% (6,415 of 12,235) of mitral valve surgery patients, 28% (2,965 of 10,590) of those having aortic valve surgery, and 24% (5,438 of 22,388) of those having isolated coronary artery bypass grafting. After adjusting for differences in preoperative characteristics, mitral valve surgery patients with a surgical AF correction procedure did not have a significantly higher risk of mortality (adjusted odds ratio, 1.00; 95% confidence interval, 0.83 to 1.20) or major morbidity. The risk for new permanent pacemaker implantation was higher (adjusted odds ratio, 1.26; 95% confidence interval, 1.07 to 1.49) in the AF correction with mitral valve surgery group.Conclusions Although a growing number of patients with AF are treated with concurrent AF correction procedures during cardiac surgery, nearly 60% of patients are left untreated. Among patients with AF and mitral valve disease, the addition of an AF correction procedure does not increase perioperative morbidity or mortality.
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In the same Society of Thoracic Surgeons database analysis, pacemaker implantation was more frequent with concomitant atrial fibrillation surgery (adjusted OR 1.26; 95% CI 1.07-1.49).
“but pacemaker implantation was more frequent (adjusted OR 1.26; 95% CI 1.07-1.49).799”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [799]
In an analysis of the Society of Thoracic Surgeons database comprising 67,389 patients in atrial fibrillation, mortality or major morbidity was not affected by concomitant atrial fibrillation surgery (adjusted OR 1.00; 95% CI 0.83-1.20).
“mortality or major morbidity was not affected by concomitant AF surgery (adjusted OR 1.00; 95% CI 0. 83-1.20)”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [799]
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- Authors
- Gammie, J. S., Haddad, M., Milford-Beland, S., Welke, K. F., Ferguson, T. B., O’Brien, S. M., Griffith, B. P., & Peterson, E. D.
- Affiliations
- University of Maryland Medical Center (US)
- Oregon Health & Science University (US)
- East Carolina University (US)
- Duke University (US)
- Corresponding author
- Gammie, James S.
- ORCID
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2008-03
- Volume
- 85
- Issue
- 3
- Pages
- 909-914
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2050704333
- Cited by
- 264
- References
- 18
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 18 · 2023: 9 · 2022: 14 · 2021: 8 · 2020: 18 · 2019: 18 · 2018: 22 · 2017: 20 · 2016: 13 · 2015: 14 · 2014: 19 · 2013: 18 · 2012: 19
- FWCI
- 9.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- atrial fibrillation, mitral valve surgery, combined surgery, cardiac surgery outcomes, mortality, morbidity, permanent pacemaker implantation, aortic valve surgery, coronary artery bypass grafting
- MeSH terms
- Aged, Coronary Artery Bypass, Atrial Fibrillation, Female, Cardiac Surgical Procedures, Heart Valve Diseases, Humans, Male, Mitral Valve, Retrospective Studies, Databases, Factual
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