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rdf:type
Description
  • Aims Surgical ablation procedure can restore sinus rhythm (SR) in patients with atrial fibrillation (AF) undergoing cardiac surgery. However, it is not known whether it has any impact on long-term clinical outcomes.Methods and results This multicentre study randomized 224 patients with AF scheduled for valve and/or coronary surgery: group A (left atrial surgical ablation, n = 117) vs. group B (no ablation, n = 107). The primary efficacy outcome was the SR presence (without any AF episode) during a 24 h electrocardiogram (ECG) after 1 year. The primary safety outcome was the combined endpoint of death/myocardial infarction/stroke/renal failure at 30 days. A Holter-ECG after 1 year revealed SR in 60.2 of group A patients vs. 35.5 in group B (P = 0.002). The combined safety endpoint at 30 days occurred in 10.3 (group A) vs. 14.7 (group B, P = 0.411). All-cause 1-year mortality was 16.2 (A) vs. 17.4 (B, P = 0.800). Stroke occurred in 2.7 (A) vs. 4.3 (B) patients (P = 0.319). No difference (A vs. B) in SR was found among patients with paroxysmal (61.9 vs. 58.3) or persistent (72 vs. 50) AF, but ablation significantly increased SR prevalence in patients with longstanding persistent AF (53.2 vs. 13.9, P < 0.001). Conclusion Surgical ablation improves the likelihood of SR presence post-operatively without increasing peri-operative complications. However, the higher prevalence of SR did not translate to improved clinical outcomes at 1 year. Further follow-ups (e.g. 5-year) are warranted to show any potential clinical benefit which might occur later
  • Aims Surgical ablation procedure can restore sinus rhythm (SR) in patients with atrial fibrillation (AF) undergoing cardiac surgery. However, it is not known whether it has any impact on long-term clinical outcomes.Methods and results This multicentre study randomized 224 patients with AF scheduled for valve and/or coronary surgery: group A (left atrial surgical ablation, n = 117) vs. group B (no ablation, n = 107). The primary efficacy outcome was the SR presence (without any AF episode) during a 24 h electrocardiogram (ECG) after 1 year. The primary safety outcome was the combined endpoint of death/myocardial infarction/stroke/renal failure at 30 days. A Holter-ECG after 1 year revealed SR in 60.2 of group A patients vs. 35.5 in group B (P = 0.002). The combined safety endpoint at 30 days occurred in 10.3 (group A) vs. 14.7 (group B, P = 0.411). All-cause 1-year mortality was 16.2 (A) vs. 17.4 (B, P = 0.800). Stroke occurred in 2.7 (A) vs. 4.3 (B) patients (P = 0.319). No difference (A vs. B) in SR was found among patients with paroxysmal (61.9 vs. 58.3) or persistent (72 vs. 50) AF, but ablation significantly increased SR prevalence in patients with longstanding persistent AF (53.2 vs. 13.9, P < 0.001). Conclusion Surgical ablation improves the likelihood of SR presence post-operatively without increasing peri-operative complications. However, the higher prevalence of SR did not translate to improved clinical outcomes at 1 year. Further follow-ups (e.g. 5-year) are warranted to show any potential clinical benefit which might occur later (en)
Title
  • Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study
  • Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study (en)
skos:prefLabel
  • Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study
  • Comparison of cardiac surgery with left atrial surgical ablation vs. cardiac surgery without atrial ablation in patients with coronary and/or valvular heart disease plus atrial fibrillation: final results of the PRAGUE-12 randomized multicentre study (en)
skos:notation
  • RIV/00064173:_____/12:43906577!RIV13-MZ0-00064173
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I, Z(MSM0021620817)
http://linked.open...iv/cisloPeriodika
  • 21
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 127885
http://linked.open...ai/riv/idVysledku
  • RIV/00064173:_____/12:43906577
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Cardiac surgery; Maze; Surgical ablation; Atrial fibrillation (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • GB - Spojené království Velké Británie a Severního Irska
http://linked.open...ontrolniKodProRIV
  • [5BADFF8B58F5]
http://linked.open...i/riv/nazevZdroje
  • European Heart Journal
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 33
http://linked.open...iv/tvurceVysledku
  • Osmančík, Pavel
  • Vaněk, Tomáš
  • Widimský, Petr
  • Budera, Petr
  • Fojt, Richard
  • Hlavička, Jan
  • Jelínek, Štěpán
  • Straka, Zbyněk
http://linked.open...ain/vavai/riv/wos
  • 000310628700012
http://linked.open...n/vavai/riv/zamer
issn
  • 0195-668X
number of pages
http://bibframe.org/vocab/doi
  • 10.1093/eurheartj/ehs290
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