Guía ESC 2020 sobre el diagnóstico y tratamiento de la fibrilación auricular, desarrollada en colaboración de la European Association of Cardio-Thoracic Surgery (EACTS)

Hindricks, Gerhard; Potpara, Tatjana; Dagres, Nikolaos; Arbelo, Elena; Bax, Jeroen J.; Blomström‐Lundqvist, Carina; Boriani, Giuseppe; Castellà, Manuel; Dan, Gheorghe‐Andrei; Dilaveris, Polychronis; Fauchier, Laurent; Filippatos, Gerasimos; Kalman, Jonathan M.; Meir, Mark La; Lane, Deirdre A.; Lebeau, Jean‐Pierre; Lettino, Maddalena; Lip, Gregory Y.H.; Pinto, Fausto J.; Thomas, G. Neil; Valgimigli, Marco; Gelder, Isabelle C. Van; Putte, Bart P. van; Watkins, Caroline L

doi:10.1016/j.recesp.2020.10.022

Cited by 33 publications

(58 citation statements)

References 1,374 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Monitoring of patients undergoing surgical or catheter ablation of AF has evolved remarkably over the last years. Current guidelines emphasize the relevance of patient-reported outcomes, meaning that if the patient feels better, the ablation procedure has been successful (1). The issue of patient-reported outcomes has fostered a debate on the follow-up protocols to be adopted in ablated patients.…”

Section: Discussionmentioning

confidence: 99%

“…AF de nition followed current guideline classi cation (1). In particular, paroxysmal AF was de ned as a self-terminating AF episode (up to 7 days), and persistent AF was de ned as an AF episode lasting longer than 7 days, or requiring termination by electrical or pharmacological cardioversion (1).…”

Section: Methodsmentioning

confidence: 99%

“…Much debate is still going on about the best ablation strategy for the treatment of atrial brillation (AF), which prompted the latest 2020 update of the European Society of Cardiology/European Association of Cardio-Thoracic Surgery (ESC/EACTS) guidelines for the management of AF for improving adherence to practice guidelines among healthcare professionals (1). Among the 2020 ESC/EACTS recommendations, cardiac surgery may play a role in speci c patient subsets.…”

Section: Introductionmentioning

confidence: 99%

“…However, despite the large number of catheter ablation procedures performed, only few patients undergo multidisciplinary heart team discussion for proper decision making about patient-tailored or optimal therapeutic strategy, like hybrid AF ablation procedure (1).…”

Section: Introductionmentioning

confidence: 99%

“…In particular, by comparing guideline recommendations of 2016 vs 2020, catheter or surgical ablation should be considered in patients with symptomatic persistent or long-standing persistent AF (Class IIb in 2016), but only AF catheter ablation for PV isolation is recommended for rhythm control after one failed or intolerant drug therapy (Class I in 2020) (1). Thoracoscopic or hybrid surgical ablation for patients refractory to drug therapy or after failed percutaneous AF ablation stays as a Class IIa recommendation (1).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Fate of Patients After Failed Epicardial Ablation of Atrial Fibrillation

Nasso¹,

Lorusso

Motekallemi

et al. 2021

Preprint

View full text Add to dashboard Cite

Background – Much debate is still going on about the best ablation strategy – via endocardial or epicardial approach – in patients with atrial fibrillation (AF), and evidence gaps exist in current guidelines in this area. More specifically, there are no clear long-term outcome data after failed surgical AF ablation.Methods – Since June 2008, 549 surgical AF ablation procedures through a right minithoracotomy were performed at our institution. From 2008 to 2011, a unipolar radiofrequency device was used (151 patients), whereas from 2011 to 2020 a bipolar radiofrequency device was used (398 patients). Patients were scheduled for surgery on the basis of the following criteria: recurrent episodes of paroxysmal or persistent lone AF refractory to maximally tolerated antiarrhythmic drug dosing and at least one failed cardioversion attempt. Besides the recommended follow-up by the local cardiologist, starting from 2021, surviving patients were asked to undergo assessment of left ventricular function and to complete a questionnaire addressing quality of life and predisposing factors for recurrent AF.Results – At a mean follow-up of 77 months, the rate of AF recurrence was 20.7% (n=114). On multivariate analysis, impaired left ventricular ejection fraction (58 patients, 51%, p=0.002), worsening of European Heart Rhythm Association (EHRA) symptom class (37 patients, 32%, p=0.003) and cognitive decline or depression (23 patients, 20%, p=0.023) during follow-up were found to be significantly associated with AF recurrence.Conclusions – Surgical AF ablation through a right minithoracotomy is safe, but a better outcome could be achieved using a hybrid approach. Patients after initial failed surgical AF ablation show worsening of cardiac function, clinical status and quality of life at follow-up compared to patients with successful AF ablation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations