Cited by 294Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

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Surgical ablation as treatment for the elimination of atrial fibrillation: A meta-analysis

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Barnett, Scott D., Ad, Niv·2006·The Journal of Thoracic and Cardiovascular Surgery

DOI 10.1016/j.jtcvs.2005.10.020

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Abstract

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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Authors: Barnett, S. D., & Ad, N.
Affiliations: Inova Health System (US)
Corresponding author: Barnett, Scott D.
ORCID: Barnett, Scott D.
Ad, Niv
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)
DOI: 10.1016/j.jtcvs.2005.10.020
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: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 3719 d)
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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Surgical ablation as treatment for the elimination of atrial fibrillation: A meta-analysis

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