Surgical ablation as treatment for the elimination of atrial fibrillation: a meta-analysis
Open accessAbstract
Objective The maze procedure is recognized as the most effective surgical treatment of atrial fibrillation. In the last few years, new surgical ablation techniques were developed involving the left atrium only and modifications of the maze procedure in ablating both atria. For this study, we evaluated the evidence regarding the effectiveness of the surgical ablation procedures (biatrial and left atrial) in reducing postoperative atrial fibrillation and subsequent survival.Methods MEDLINE was searched for English-language studies using the terms "maze," "atrial fibrillation," and "surgical treatment" for 1995 through August 2005. Primary outcomes of interest were postoperative survival and postoperative freedom from atrial fibrillation. Survival data were collected at 1-, 2-, and 3-year intervals. Freedom from atrial fibrillation was collected at 3 months and at 1-, 2-, and 3-year intervals.Results Sixty-nine studies were included in this analysis. Five thousand eight hundred eighty-five total patients were involved. Patients undergoing surgical ablation (range, 90.4-85.4) demonstrated significantly greater rates of freedom from atrial fibrillation compared with those seen in control patients (range, 47.2-60.9). Survival rates among patients with biatrial surgical procedures (range, 94.9-92.8) were similar to those who had left atrial procedures only (range, 93.9-89.4). However, patients undergoing biatrial ablation (range, 92.0-87.1 vs 86.1-73.4) demonstrated superior freedom from atrial fibrillation at all time points.Conclusion Biatrial ablation surgical procedures were more effective in controlling atrial fibrillation than procedures confined to the left atrium. To encourage the use of future meta-analysis within the surgical literature, we suggest the more frequent reporting of either through Kaplan-Meier survival analyses and the reporting of rates for specific time intervals.
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Biatrial lesion patterns may be more effective in persistent and long-standing persistent atrial fibrillation.
“Biatrial lesion patterns may be more effective in persistent and long-standing persistent AF. 797,803,806”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [797]
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Chaiyaroj, S., Ngarmukos, T., & Lertsithichai, P. (2008) · Asian Cardiovascular and Thoracic Annals · doi:10.1177/021849230801600407 · Cited by 22 · see citing works
Pecha, S., Aydin, M. A., Ahmadzade, T., Hartel, F., Hoffmann, B. A., Steven, D., Willems, S., Reichenspurner, H. C., & Wagner, F. (2015) · Heart and Vessels · doi:10.1007/s00380-015-0735-4 · Cited by 22 · see citing works
The Surgical Treatment of Concomitant Atrial Arrhythmias During Redo Cardiac Operations
Stulak, J. M., Dearani, J. A., Burkhart, H. M., Park, S. J., Suri, R. M., & Schaff, H. V. (2012) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2012.07.040 · Cited by 22 · see citing works
Current Hot Potatoes in Atrial Fibrillation Ablation
Roten, L., Derval, N., Pascale, P., Scherr, D., Komatsu, Y., Shah, A. J., Ramoul, K., Denis, A., Sacher, F., Hocini, M., et al. (2012) · Current Cardiology Reviews · doi:10.2174/157340312803760802 · Cited by 21 · see citing works
Ad, N. (2007) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2007.04.043 · Cited by 22 · see citing works
Self-citationIm, Y.-M., Kim, J. B., Yun, S., Lee, J. W., Chung, C. H., Park, J., & Yun, T.-J. (2013) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2012.12.002 · Cited by 22 · see citing works
Choice of Surgical Lesion Set: Answers From the Data
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Surgical Treatment of Atrial Fibrillation: Today’s Questions and Answers
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Guía de práctica clínica sobre revascularización miocárdica
Wijns, W. C., Kolh, P. H., Danchin, N., Mario, C. D., Falk, V., Folliguet, T. A., Garg, S., Huber, K., James, S. K., Knuuti, J. M., et al. (2010) · Revista Española de Cardiología · doi:10.1016/s0300-8932(10)70277-3 · Cited by 17 · see citing works
- Authors
- Barnett, S. D., & Ad, N.
- Affiliations
- Inova Health System (US)
- Corresponding author
- Barnett, Scott D.
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2006-05
- Volume
- 131
- Issue
- 5
- Pages
- 1029-1035
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2053700528
- Cited by
- 294
- References
- 81
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 11 · 2023: 7 · 2022: 9 · 2021: 8 · 2020: 13 · 2019: 11 · 2018: 16 · 2017: 25 · 2016: 15 · 2015: 13 · 2014: 17 · 2013: 15 · 2012: 21
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular 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 pacing and defibrillation studies
- Keywords
- atrial fibrillation, surgical ablation, maze procedure, biatrial ablation, left atrial ablation, postoperative atrial fibrillation, postoperative survival, atrial fibrillation recurrence
- MeSH terms
- Atrial Fibrillation, Humans, Recurrence, Survival Analysis, Treatment Outcome, Catheter Ablation
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