Cor Vasa 2025, 67(3):367-375 | DOI: 10.33678/cor.2025.007

Efficacy of Left Atrial Radiofrequency Surgical Ablation in Patients with Atrial Fibrillation and Concomitant Cardiac Surgical Pathology

Olha Shepetko-Dombrovskaa, Serhii Varbanetsa, Pavlo Shepetko-Dombrovskyia, Ivanna Zubovychb, Nadiya Rudenkoc
a Department of Adult Cardiac Surgery, Clinic for Adults, Scientific-Practical Medical Center for Pediatric Cardiology and Cardiac Surgery, Kyiv, Ukraine
b Department of Cardiometabolic Diseases, Clinic for Adults, Scientific-Practical Medical Center for Pediatric Cardiology and Cardiac Surgery, Kyiv, Ukraine
c Department of Children's Cardiology and Cardiac Surgery, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

Aim: The aim of the study was to determine the feasibility of left atrial surgical ablation in patients with atrial fibrillation and concomitant cardiovascular diseases.

Methods: The experiment was conducted at the Scientific and Practical Medical Centre of Paediatric Cardiology and Cardiac Surgery, Adult Clinic (Kyiv, Ukraine, 2024). A total of 69 patients who underwent surgical treatment for atrial fibrillation and concomitant cardiovascular disease took part in the study.

Results: It was found that after the procedure of left atrial surgical ablation of the atrial fibrillation focus, the sinus node was the rhythm driver in 45 patients (65% of all). In 18 patients (26%), rhythm disturbances remained in the form of atrial fibrillation, 4 patients (6%) had atrial flutter, and 2 patients (3%) had left atrial flutter. Among the study participants, almost 61% (42 patients) had a long-standing form of atrial fibrillation and an average left atrial size of 5.2 ± 0.6 cm, which significantly worsened the results of surgical treatment. The efficacy of radiofrequency ablation was lower in patients with traditional predictors of failure, namely, patients over 70 years of age, left atrial size of 5 cm or more, atrial fibrillation duration of more than 5 years, and persistent and long-standing atrial fibrillation.

Conclusions: The study concluded that radiofrequency ablation of the left atrium alone was conditionally successful in patients with shorter duration of atrial fibrillation and smaller left atrial size.

Keywords: Cardiac arrhythmias, Cardiovascular diseases, Thoracoscopic access, Hybrid techniques, Cox-Maze IV surgery,

Received: November 29, 2024; Revised: January 6, 2025; Accepted: January 14, 2025; Prepublished online: June 2, 2012; Published: June 20, 2025  Show citation

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Shepetko-Dombrovska O, Varbanets S, Shepetko-Dombrovskyi P, Zubovych I, Rudenko N. Efficacy of Left Atrial Radiofrequency Surgical Ablation in Patients with Atrial Fibrillation and Concomitant Cardiac Surgical Pathology. Cor Vasa. 2025;67(3):367-375. doi: 10.33678/cor.2025.007.
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    References

    1. Sagris M, Vardas EP, Theofilis P, et al. Atrial fibrillation: Pathogenesis, predisposing factors, and genetics. Int J Mol Sci 2022;23:6. Go to original source... Go to PubMed...
    2. Aldaas OM, Malladi CL, Hsu JC. Catheter ablation of atrial fibrillation in patients with heart failure. Am J Cardiol 2019;123:187-195. Go to original source... Go to PubMed...
    3. Al-Ezzi SMS, Bista I, Al-Ezzi MM, et al. Updates in the management of atrial fibrillation: Emerging therapies and treatment. Dis Mon 2024;70:101633. Go to original source... Go to PubMed...
    4. Ren L, Li W, Su X, et al. Follow-up study of depressive state on patients with atrial fibrillation 1 year after radio-frequency ablation. Front Psychiatr 2022;13:1046924. Go to original source... Go to PubMed...
    5. Volgman AS, Nair G, Lyubarova R, et al. Management of atrial fibrillation in patients 75 years and older: JACC state-of-the-art review. J Am Coll Cardiol 2022;79:166-179. Go to original source... Go to PubMed...
    6. Ferro EG, Reynolds MR, Xu J, et al. Outcomes of atrial fibrillation ablation among older adults in the United States: A nationwide study. JACC Clin Electrophysiol 2024;10:1341-1350. Go to original source... Go to PubMed...
    7. Cheng EP, Liu CF, Yeo I, et al. Risk of mortality following catheter ablation of atrial fibrillation. J Am Coll Cardiol 2019;74:2254-2264. Go to original source... Go to PubMed...
    8. Skybchyk YV, Mikhaliev KО, Zharinov OJ. Association of left atrial spontaneous echo contrast with clinical and hemodynamic characteristics of patients with long-term episodes of persistent atrial fibrillation. Med News 2022;75:2652-2657. Go to original source... Go to PubMed...
    9. Leszto K, Frąk W, Kurciński S, et al. Associations of dietary and lifestyle components with atrial fibrillation. Nutrients 2024;16:456. Go to original source... Go to PubMed...
    10. Joglar JA, Chung MK, Armbruster AL, et al. ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circ 2024;149: e1-e156. Go to original source... Go to PubMed...
    11. Bisleri G, Pandey AK, Verma S, et al. Combined minimally invasive surgical and percutaneous catheter ablation of atrial fibrillation. J Am Coll Cardiol 2023;81: 606-619. Go to original source... Go to PubMed...
    12. Peigh G, Zhou J, Rosemas SC, et al. Association of atrial fibrillation burden and mortality among patients with cardiac implantable electronic devices. Circ 2024;150:350-361. Go to original source...
    13. Ravshanov AX, Suhail M, Komilova N, et al. Medical geographical zoning in part of Uzbekistan - A regional synthesis. Reg Sci Pol Pract 2024;16:100142. Go to original source...
    14. Sokól-Szawlowska M. Paternal perinatal depression: cases. Psych Pol 2020;54:1123-1135. Go to original source... Go to PubMed...
    15. Tomasz O, Waldemar K, Kajetan Ł, et al. Robotics in Neurosurgery - Past, Presence and Future. Adv Intell Syst Comp 2021;1362:1-8. Go to original source...
    16. Serkova VK, Pavlov SV, Romanava VA, et al. Medical expert system for assessment of coronary heart disease destabilization based on the analysis of the level of soluble vascular adhesion molecules. Proc SPIE Int Soc Optic Eng 2017;10445:104453O. Go to original source...
    17. Hanafy DA, Erdianto WP, Husen TF, et al. Three ablation techniques for atrial fibrillation during concomitant cardiac surgery: A systematic review and network meta-analysis. J Clin Med 2023;12:5716. Go to original source... Go to PubMed...
    18. van der Heijden CAJ, Weberndörfer V, Luermans JGLM, et al. Hybrid ablation of atrial fibrillation: A unilateral left-sided thoracoscopic approach. J Card Surg 2022;37:4630-4638. Go to original source... Go to PubMed...
    19. Kaba RA, Ahmed O, Behr E, Momin A. A chronicle of hybrid atrial fibrillation ablation therapy: From Cox Maze to convergent. Arrhythm Electrophysiol Rev 2022;11:e12. Go to original source... Go to PubMed...
    20. Jing M, Li D, Xi H, et al. Value of imaging in the non-invasive prediction of recurrence after catheter ablation in patients with atrial fibrillation: An up-to-date review. Rev Cardiovasc Med 2023;24:241. Go to original source... Go to PubMed...
    21. Rudyk DV, Tutchenko MI, Chub SL, et al. Portal hypertension and emergency care. Wiad Lek Wars Pol 2024;77:1485-1489. Go to original source... Go to PubMed...
    22. Koutsaki S, Koutelekos I, Gerogianni G, et al. Atrial fibrillation in hypertension: Patients' characteristics. Mater Sociomed 2018;30:4-9. Go to original source... Go to PubMed...
    23. Lapa ME, Swabe GM, Magnani JW. Association of depression and adherence to oral anticoagulation in patients with atrial fibrillation. J Am Heart Assoc 2023;12:e031281.
    24. Zhang S, Zhang N, Liu L, et al. Global epidemiology of mental disorder in atrial fibrillation between 1998-2021: A systematic review and meta-analysis. World J Psychiatr 2024;14:179-193. Go to original source... Go to PubMed...
    25. Le Grande MR, Salvacion M, Shwaita L, et al. Does coping style mediate the relationship between knowledge and psychosocial outcomes in women with atrial fibrillation? Front Psychiatr 2024;15:1328111. Go to original source... Go to PubMed...
    26. Holmes DN, Piccini JP, Allen LA, et al. Defining clinically important difference in the atrial fibrillation effect on quality-of-life score: Results from the outcomes registry for better informed treatment of atrial fibrillation. Circ Cardiovasc Qual Outcomes 2019;12:e005358. Go to original source... Go to PubMed...
    27. Chen YP, Li D, Xu YQ, et al. 5-Azacytidine accelerates mandarin fruit post-ripening and enhances lignin-based pathogen defense through remarkable gene expression activation. Food Chem 2024a;458:140261. Go to original source... Go to PubMed...
    28. Chen YP, Xu YQ, Han XY, et al. Azacytidine shows potential in controlling the chilling injury of banana peel during cold storage. Food Cont 2024b;159:110283. Go to original source...
    29. Vos LM, Vos R, Nieuwkerk PT, et al. Quality of life improvement from thoracoscopic atrial fibrillation ablation in women versus men: A prospective cohort study. Interdiscip Cardiovasc Thorac Surg 2024;39:ivae132. Go to original source... Go to PubMed...
    30. Gupta D, Vijgen J, De Potter T, et al. Quality of life and healthcare utilisation improvements after atrial fibrillation ablation. Heart 2021;107:1296-1302. Go to original source... Go to PubMed...
    31. Terricabras M, Mantovan R, Jiang C-Y, et al. Association between quality of life and procedural outcome after catheter ablation for atrial fibrillation: A secondary analysis of a randomized clinical trial. JAMA Netw Open 2020;3:e2025473. Go to original source... Go to PubMed...
    32. Keum H, Cevik E, Kim J, et al. Tissue ablation: Applications and perspectives. Adv Mater 2024;36:e2310856. Go to original source... Go to PubMed...
    33. Boersma L, Andrade JG, Betts T, et al. Progress in atrial fibrillation ablation during 25 years of Europace journal. EP Europace 2023;25:euad244. Go to original source... Go to PubMed...
    34. Malagoli A, Rossi L, Bursi F, et al. Left atrial function predicts cardiovascular events in patients with chronic heart failure with reduced ejection fraction. J Am Soc Echocardiogr 2019;32:248-256. Go to original source... Go to PubMed...
    35. Zolotarova TV, Brynza MS, Volkov DY, et al. Predictors of atrial fibrillation recurrence after radiofrequency ablation in patients with chronic heart failure. Med News 2021;74:1850-1855. Go to original source...
    36. Oliinyk Y, Maltsev D, Shydlovska O, et al. Integrated Approach to Diagnosis and Treatment in Clinical Medicine: Search for Optimal Solutions. J Pion Med Sci 2024;13:12-21. Go to original source...
    37. Khan HR, Yakupoglu HY, Kralj-Hans I, et al. Left atrial function predicts atrial arrhythmia recurrence following ablation of long-standing persistent atrial fibrillation. Circ Cardiovasc Imaging 2023;16:e015352. Go to original source... Go to PubMed...
    38. Tian X, Zhang X-J, Yuan Y-F, et al. Morphological and functional parameters of left atrial appendage play a greater role in atrial fibrillation relapse after radiofrequency ablation. Sci Rep 2020;10:8072. Go to original source... Go to PubMed...
    39. Smiyan OI, Loboda AM, Manko YA, et al. Dynamics of content of some minerals in teenagers with cardiovascular system pathology against the background of chronic tonsillitis. Wiad Lek Wars Pol 2018;71:861-864.
    40. Khiabani AJ, MacGregor RM, Bakir NH, et al. The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation. J Thorac Cardiovasc Surg 2022;163:629.e7-641.e7. Go to original source... Go to PubMed...
    41. MacGregor RM, Khiabani AJ, Bakir NH, et al. Impact of obesity on atrial fibrillation recurrence following stand-alone Cox Maze IV procedure. Innov Technol Tech Cardiothorac Vasc Surg 2021;16:434-440. Go to original source... Go to PubMed...
    42. Efremov A. Psychosomatics: Communication of the Central Nervous System through Connection to Tissues, Organs, and Cells. Clin Psychopharm Neurosci 2024;22:565-577. Go to original source... Go to PubMed...

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