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Curso de Atualização em Medicina Cardiovascular 2019
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
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15. Valvular Heart Disease
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19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Surgical treatment of atrial fibrillation
Session:
Posters 5 - Écran 3 - Arritmologia
Speaker:
Rui Pedro Cerejo
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.4 Atrial Fibrillation - Treatment
Session Type:
Posters
FP Number:
---
Authors:
Rui Pedro Cerejo; Carolina Rodrigues; Manuela Gouveia Silva; Nuno Banazol; Rui Rodrigues; José Fragata
Abstract
<p><strong>Introduction</strong></p> <p>AF is the most common cardiac arrhythmia, and its prevalence is increasing at an alarming rate worldwide. It remains one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity. Surgical ablation is currently considered an effective treatment for patients with AF, with recent international guidelines advocating it for patients with symptomatic AF be as stand-alone or concomitant surgery. Despite this, it is still underperformed in most centers. </p> <p><strong>Objectives</strong></p> <p>To evaluate the early results of an Atrial Fibrillation (AF) ablation surgery program.</p> <p><strong>Methods</strong></p> <p>All patients submitted to some form of surgical AF ablation (concomitant or stand-alone) from March 2016 till October 2018 were included in this unicentric retrospective study. </p> <p>The indication for stand-alone surgery was symptomatic AF relapse after catheter ablation, and for concomitant surgery, symptomatic AF associated with structural heart disease. Cryoablation was used in open-right or left atrium surgery and radiofrequency in the other cases. The main primary outcome was establishment and duration of sinus rhythm in the course of follow-up. Mortality and morbidity (stroke, pace-maker implantation) were assessed.</p> <p><strong>Results</strong></p> <p>Thirty patients with mean age of 60.7 years (36-75years) were submitted to surgical AF ablation. AF type was paroxysmal in 12 (40.0%), persistent in 4 (13.3%) and long-standing persistent in 14 (46.7%). Stand-alone AF ablation surgery was performed in 11 patients (36.7%) and in 19 patients (63.3%) was associated with concomitant procedures: mitral surgery (n=8), tricuspid surgery (n=3), aortic valve surgery (n=3), CABG (n=2) and double valve surgery (n=3). Regarding complications: two (6.7%) definitive pacemaker implantations were needed and one (3.3%) early death was observed. There were no strokes or late mortality.</p> <p>Sinus rhythm at hospital discharge was present in 25 patients (86.2%). After 6 months 81.0% were in sinus rhythm. Mean follow-up time was 10 months and i the last evaluation 23 patients (76,7%) had no evidence of AF.</p> <p><strong>Conclusions</strong></p> <p>Surgical AF ablation is a safe procedure with better results compared with those reported for catheter ablation. We demonstrate that even in an initial phase of a surgical program, results are satisfactory and encouraging. Finally, surgical AF ablation is still an underused procedure which has to grow to keep up with demand of AF treatment.</p>
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