Biatrial or Left Atrial Lesion Set for Ablation During Mitral Surgery: Risks and Benefits

Safety and efficacy of biatrial vs left atrial surgical ablation during concomitant cardiac surgery: A meta‐analysis of clinical studies with a focus on the causes of pacemaker implantation

“…In 10 studies (35.7%) mitral surgery was the main procedure performed in association with AF ablation, while in the remaining studies various types of main procedures (coronary surgery, valve surgery, aortic surgery, etc) were performed aside of AF ablation. Four studies enrolled only patients rheumatic valve disease (RVD) in both study groups, while 4 more studies reported a variable quota of RVD ranging between 50% and 70% of the population, while in the remaining 20 studies the incidence of RVD was not clearly stated.…”

“…Ten studies (35.7%) enrolled patients whose the main surgical procedure was on the mitral valve and had concomitant AF ablation. The comparison of preoperative and intraoperative characteristics in this subgroup, did not show any significant unbalancing between BA and LA patients characteristics, except as expected, the length of cardiopulmonary bypass (WMD 14.30 minutes, CI, 2.72‐25.88 minutes, P = .02) and cross‐clamp (WMD 9.88 minutes, CI = 1.70‐18.05 minutes, P = .02) that were longer in the BA group (see Supplementary Material S4).…”

“…3,4,21,22,24,25,27,31,32,37 The remaining 15 studies (53.6%) were retrospective observational, of which 3 were propensity adjusted. 5,19,20,26,[28][29][30]33,34,38,39,[44][45][46][47] In 16 studies (57.1%) all the patients enrolled presented exclusively non-paroxysmal AF forms and these studies constituted the "non-paroxysmal AF subgroup." [20][21][22][23][25][26][27][28][34][35][36][37][38][39]46,47 clearly specify the types of AF included.…”

“…In 10 studies (35.7%) mitral surgery was the main procedure performed in association with AF ablation, 19 Within studies adopting CM4, radiofrequency was the most common energy source used to perform the ablation: it was used in 11 studies (39.3%) as the only source of energy in both study groups, [21][22][23]25,26,34,35,37,44,45,47 while in 5 studies (17.8%) radiofrequency mainly used but it was complemented by cryoablation for some lesions. 19,20,24,30,36 These 16 studies were included in the Radiofrequency subgroup.…”

Comparative analysis of the requirement for pacemaker implantation in the left atrial and biatrial concomitant ablation in patients with valvular heart disease

“…Churyla et al продемонстрировали, что разница в частоте имплантации ЭКС у пациен-тов с дисфункцией атриовентрикулярного узла отсутствует (12% против 12%, р = 0,57) [20]. A.M. Gillinov et al в результатах своего исследо-вания также указывают на то, что отсутствует какая-либо разница по частоте имплантации ЭКС между ЛП-и БА-подгруппами (10 пациен-тов, 14,9%; 16 пациентов, 24,2%; р = 0,22) [1].…”