Predictors of short- and mid-term recurrence of atrial fibrillation after surgical radiofrequency ablation: A six-month transtelephonic electrocardiogram monitoring study

Abstract

Background: Occurrence of symptomatic, paroxysmal or persistent atrial fibrillation (AF) prior to admission to hospital for the purposes of cardiac surgery constitutes an indication forconsideration of simultaneous surgical radiofrequency (RF) ablation of such tachyarrhythmia. The aim of this study was to evaluate the efficacy of surgical RF ablation in the treatment of AF with the application of ECG teletransmission in monitoring patients during a 6-month follow-up period. Furthermore, clinical and echocardiographic risk factors for arrhythmia recurrences were subject to analysis. As per authors’ knowledge and literature review, so far no papers devoted to the assessment of efficacy of surgical RF ablation with the use of systematic ECG teletransmission have been published.

Methods: The study enrolled 61 patients (20 females) suffering from AF who underwent cardiac surgeries and were additionally subject to surgical RF ablation. The mean age of the subjects was 64 ± 9 years. Efficacy of the procedure was monitored with the application of a system enabling transtelephonic transmission of ECG signal. The study cohort was monitored in the period of 6 months. 2198 ECG recordings were obtained for analysis.

Results: In the post-hospital follow-up period, no recurrences of AF were observed in the case of 40 (65%) subjects. Post-hospital failure of the surgical RF ablation procedure was associated with an early episode of AF during hospitalization (p = 0.0012), application of monopolar electrode (p = 0.0325) as well as with the surgical procedure performed to treat mitral stenosis (p = 0.0268).

Conclusions: Moreover, it was observed that the group of patients without arrhythmia recurrence in the follow-up period was more frequently administered with antiarrhythmic medications (p = 0.0409) and statin (p = 0.0453) prior to the ablation procedure, with statin being more often applied after the procedure (tendency, p = 0.0747). As opposed to ablation in one atrium, biatrial ablation did not result in fewer late arrhythmia recurrences.