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. 2015 Oct 31;8(3):1269.
doi: 10.4022/jafib.1269. eCollection 2015 Oct-Nov.

Development Of A Novel Scoring System That Determines The Success Of Atrial Fibrillation Ablation As Part Of Cardiac Surgery

Norton A  1 , D Schlosshan  2 , I Ahmed  3 , M H Tayebjee  2
Affiliations

Development Of A Novel Scoring System That Determines The Success Of Atrial Fibrillation Ablation As Part Of Cardiac Surgery

Norton A et al. J Atr Fibrillation. .

Abstract

Background: Radiofrequency ablation therapy for the treatment of atrial fibrillation (AF) can be performed as a concomitant procedure alongside cardiac surgery, but carries the risks of increased bypass time and damage to the sinoatrial node. This study aims to assess the efficacy of concomitant surgical AF ablation and develop a novel scoring system to predict post-procedural return to sinus rhythm.

Methods: A review of the Leeds General Infirmary surgical database was conducted to list all patients who had undergone valvular or coronary bypass surgery with concomitant AF ablation between Jan 2012 - Dec 2013 (n = 76). Follow-up was obtained retrospectively using patient notes, clinic letters and echocardiographic data. Primary outcome was freedom from AF at median follow up (383 days). A novel scoring system was created through analysis of previous literature and evaluated using a receiver operating characteristic (ROC) curve.

Results: At median follow up 50.9% of patients undergoing the procedure were free from AF. The novel scoring system was shown to adequately predict post-procedural return to sinus rhythm (ROC AUC = 0.7708).

Conclusion: A novel scoring system was shown to predict procedural success in patients undergoing concomitant AF ablation alongside cardiac surgery. These results can be further validated using larger patient cohorts.

Keywords: AF; Ablation; Concomitant; Score; Surgical.

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Figures

Figure 1.
Figure 1.. a) Surface ECG of a patient in sinus rhythm with activated CCM. The corresponding CCM algorithm is pictured at the bottom of the figure. Abbreviations: RA= right atrial, RV= right ventricular. b) Illustration of the CCM device Optimizer IV with the external charging system. (The illustration was provided from Impulse Dynamics).
Figure 2.
Figure 2.. Receiver operating characteristic (ROC) curve for a novel predictive scoring system for concomitant surgical ablation.
See this image and copyright information in PMC

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