Left atrial concomitant surgical ablation for treatment of atrial fibrillation in cardiac surgery: A meta-analysis of randomized controlled trials

• Published in: PloS one 2018-01, Vol.13 (1), p.e0191354-e0191354
• Main Authors: Wang, Xinxin, Wang, Chunguo, Ye, Minhua, Lin, Jiang, Jin, Jiang, Hu, Quanteng, Zhu, Chengchu, Chen, Baofu
• Format: Article
• Language: English
• Subjects: Ablation; Atrial Fibrillation - complications; Atrial Fibrillation - surgery; Bias; Biology and Life Sciences; Bleeding; Cardiac arrhythmia; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - methods; Cardiac Surgical Procedures - mortality; Catheter Ablation - adverse effects; Catheter Ablation - methods; Catheter Ablation - mortality; Catheters; Clinical outcomes; Clinical trials; Collaboration; Data processing; Fibrillation; Heart; Heart Atria - surgery; Heart diseases; Heart Diseases - complications; Heart Diseases - surgery; Heart surgery; Hospitals; Humans; Implantation; Lesions; Medicine and Health Sciences; Meta-analysis; Morbidity; Mortality; Patients; Physical Sciences; Randomization; Randomized Controlled Trials as Topic; Research and Analysis Methods; Sinus; Stroke; Studies; Surgery; Systematic review; Thoracic surgery; Treatment Outcome; Veins & arteries
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0191354

Surgical ablation is a generally established treatment for patients with atrial fibrillation undergoing concomitant cardiac surgery. Left atrial (LA) lesion set for ablation is a simplified procedure suggested to reduce the surgery time and morbidity after procedure. The present meta-analysis aims to explore the outcomes of left atrial lesion set versus no ablative treatment in patients with AF undergoing cardiac surgery. A literature research was performed in six database from their inception to July 2017, identifying all relevant randomized controlled trials (RCTs) comparing left atrial lesion set versus no ablative treatment in AF patient undergoing cardiac surgery. Data were extracted and analyzed according to predefined clinical endpoints. Eleven relevant RCTs were included for analysis in the present study. The prevalence of sinus rhythm in ablation group was significantly higher at discharge, 6-month and 1-year follow-up period. The morbidity including 30 day mortality, late all-cause mortality, reoperation for bleeding, permanent pacemaker implantation and neurological events were of no significant difference between two groups. The result of our meta-analysis demonstrates that left atrial lesion set is an effective and safe surgical ablation strategy for AF patients undergoing concomitant cardiac surgery.