Left-Atrial Ablation of AFib During Mitral Valve Surgery

Promising findings from a randomized trial in patients with continuous atrial fibrillation

Nearly half of patients who are referred for mitral valve surgery have continuous atrial fibrillation (AF). Adding a left-atrial radiofrequency (RF) ablation procedure for AF during open-heart surgery has been shown to improve the chances of restoring postsurgery sinus rhythm, but supporting studies have been nonrandomized or underpowered. Now, in a randomized trial, 97 referral patients (mean age, 67) with continuous AF of at least 6 months’ duration underwent mitral valve surgery, either alone (control) or in conjunction with unipolar-RF ablation of the left atrium (a partial “maze” procedure like that developed by Cox). Mitral valve repair was done in 74% of patients and mitral valve replacement in 26%.

At 1-year follow-up, ECG evidence o…

Reviewing Author

Hugh Calkins, MD