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J Thorac Cardiovasc Surg 2008;135:727-728
© 2008 The American Association for Thoracic Surgery

Editorial

The surgical treatment for atrial fibrillation: A call for standardization

Inova Heart and Vascular Institute, Falls Church, Va

Received for publication September 15, 2007; accepted for publication October 2, 2007.

^_* Address for reprints: Niv Ad, MD, Inova Heart and Vascular Institute, 3300 Gallows Rd, Falls Church, VA 22042. (Email: nivadmd@hotmail.com).

The first 20% of the full text of this article appears below.

See related article on page 863.

 
In recent years, there has been a significant increase in the number of surgical procedures performed to ablate atrial fibrillation. As a result, a large number of publications detailing subsequent outcomes after such procedures have resulted. However, most reports do not address the true effect of the procedure on patient outcomes and well-being. Second, an additional dilemma regarding the synthesis of literature addressing surgical ablation is the lack of standardization. Patients are being treated with different ablation tools and energy sources and different lesion sets, and the follow-up with subsequent reporting fails to address the difficulties of comparisons between the programs. The literature also lacks information regarding the correlation between the success in ablating atrial fibrillation and favorable long-term outcomes. In an attempt to standardize the reports and improve our understanding as to the real effect of surgical ablation, Dr Melo established the International Registry for Atrial Fibrillation.

In this issue of the Journal, Melo and colleagues¹ discuss 5-year results from the International Registry for Atrial Fibrillation. After analysis of more than 1700 patients operated on for mitral valve disease and atrial fibrillation from participating institutions in Europe and the United States, the authors conclude that achievement of stable sinus rhythm is an excellent predictor for better survival and a decreased incidence of thromboembolic events. Among the predictors of better survival were smaller left atrial size, biatrial ablation procedures, the absence of concomitant coronary artery bypass grafting, and the lack of preoperative permanent atrial fibrillation.

Registries² generally exist to describe the natural history of disease in a nonrandomized clinical trial setting, pool a large . . . [Full Text of this Article]

Related Article

Surgery for atrial fibrillation in patients with mitral valve disease: Results at five years from the International Registry of Atrial Fibrillation Surgery

Joao Melo, Teresa Santiago, Carlos Aguiar, Eva Berglin, Michael Knaut, Ottavio Alfieri, Stefano Benussi, Haw Sie, Mathew Williams, Fernando Hornero, Giuseppi Marinelli, Paul Ridley, Enrique Fulquet-Carreras, and António Ferreira
J. Thorac. Cardiovasc. Surg. 2008 135: 863-869. [Abstract] [Full Text] [PDF]

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