![]() Nonetheless, the early recurrence of atrial arrhythmia after surgical ablation is a risk factor for longer term recurrence as was demonstrated in a study by Maroto et al., in which 106 patients underwent concomitant surgical ablation for AF. Most early arrhythmias are transient or resolve within the first month and do not represent treatment failure per se. However, other mechanisms may play a role, including inflammation resulting from atrial injury or pericarditis. Early arrhythmia may represent early reconnection or recovered conduction across lines of electrical block. The most common arrhythmias are AF and atrial flutter, with atrial tachycardia occurring less frequently ( 8). More than 90% of these arrhythmias will occur within the first ten post-operative days but can occur up to three months after surgery ( 6- 8). The characterization and management of recurrent atrial arrhythmia following surgical ablation of AF are discussed below.Įarly recurrence of atrial arrhythmia Frequency and significanceĮarly post-operative arrhythmias are common following surgical AF ablation, and occur in 43-59% of patients, even when routinely treated postoperatively with antiarrhythmic agents. Despite advances in both catheter-based and surgical treatment for AF, recurrence of atrial arrhythmias following initial invasive therapy may occur. In an analysis of the Society of Thoracic Surgeons National Cardiac Database by 2006, 40.2% of patients with AF undergoing cardiac surgery had concomitant AF surgery, and that number has certainly increased over the ensuing years ( 5). Advances in technology and technique have made surgical intervention for AF more widespread. Surgical treatment of AF may be performed on patients undergoing cardiac surgery for other reasons (concomitant surgical ablation) or as a stand-alone procedure. Over the past two decades, invasive techniques to treat AF, including catheter-based and surgical procedures, have evolved along with our understanding of the pathophysiology of this arrhythmia. Furthermore, AF may be highly symptomatic and have a significant impact on quality of life. AF is associated with significant morbidity, including increased risk of stroke, heart failure and death. In patients undergoing cardiac surgery, AF is even more common than in the general population, because coronary artery disease and valvular heart disease are risk factors for the development of AF ( 3, 4). Accepted for publication Dec 26, 2013.Ītrial fibrillation (AF) is the most common cardiac rhythm disturbance, and its incidence continues to increase ( 1, 2). Keywords: Refractory atrial fibrillation (AF) surgical ablation catheter ablation post-surgery arrhythmias The characterization and management of recurrent atrial arrhythmias following surgical ablation of AF are discussed below. The mechanism of persistent or late occurring atrial arrhythmias is complex, and these arrhythmias may be resistant to antiarrhythmic drug therapy. Early arrhythmias are generally treated with prompt electrical cardioversion with or without antiarrhythmic therapy and do not necessarily represent treatment failure. Despite improvements in outcome of both catheter-based and surgical treatment for AF, recurrence of atrial arrhythmias following initial invasive therapy may occur.Atrial arrhythmias may occur early or late in the post-operative course after surgical ablation. Over the past two decades, invasive techniques to treat atrial fibrillation (AF) including catheter-based and surgical procedures have evolved along with our understanding of the pathophysiology of this arrhythmia. ![]()
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