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Thorac Cardiovasc Surg 2023; 71(04): 243-254
DOI: 10.1055/s-0041-1730969
Original Cardiovascular

The German CArdioSurgEry Atrial Fibrillation Registry: In-Hospital Outcomes

Mahmoud Wehbe
1   Department of Cardiac Surgery, Schüchtermann-Schiller'sche Hospital Group Bad Rothenfelde, Bad Rothenfelde, Germany
,
Marc Albert
2   Department of Cardiac Surgery, Robert-Bosch-Krankenhaus GmbH, Baden-Württemberg, Germany
,
Thorsten Lewalter
3   Peter Osypka Herzzentrum - Internal Medicine, München, Germany
,
Taoufik Ouarrak
4   Stiftung für Herzinfarkt Forschung, Ludwigshafen am Rhein, Germany
,
Jochen Senges
4   Stiftung für Herzinfarkt Forschung, Ludwigshafen am Rhein, Germany
,
Thorsten Hanke
5   Asklepios Klinik Harburg, Hamburg, Germany
,
Nicolas Doll
1   Department of Cardiac Surgery, Schüchtermann-Schiller'sche Hospital Group Bad Rothenfelde, Bad Rothenfelde, Germany
,
on behalf of the CASE-AF Investigators › Author Affiliations Funding The CASE-AF registry is supported by a grant from Atricure Europe BV, De Entree 260, 1101 EE Amsterdam Z. O.
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Abstract

Background The aim of this study was to describe outcomes of patients undergoing surgical ablation for atrial fibrillation (AF) as either stand-alone or concomitant cardiosurgical procedures in Germany.

Methods Patients with AF undergoing concomitant or stand-alone surgical ablation were included in the registry. Cardiac surgery centers across Germany were invited to participate and sought to enroll 1,000 consecutive patients. Data was obtained through electronic case report forms. The protocol mandated follow-up interviews at 1 year.

Results Between January 2017 and April 2020, 17 centers enrolled 1,000 consecutive patients. Among concomitant surgical patients (n = 899), paroxysmal AF was reported in 55.4% patients. Epicardial radio frequency (RF) bilateral pulmonary vein isolation (PVI) with excision of the left atrial appendage (LAA) was the most common operative strategy. In the stand-alone cohort (n = 101), persistent AF forms were reported in 84.1% of patients. Moderate-to-severe symptoms were reported in 85.1%. Sixty-seven patients had previously underwent at least two failed catheter ablative procedures. Thoracoscopic epicardial RF bilateral PVI and completion of a “box-lesion” with LAA closure were frequently preformed. Major cardiac and cerebrovascular complications occurred in 38 patients (4.3%) in the concomitant group. No deaths were reported in the stand-alone group. At discharge, sinus rhythm was achieved in 88.1% of stand-alone and 63.4% concomitant patients.

Conclusion The CArdioSurgEry Atrial Fibrillation registry provides insights into surgical strategies for AF ablation in a considerable cohort across Germany. This in-hospital data demonstrates that concomitant and stand-alone ablation during cardiac surgery is safe and effective with low complication rates.

Keywords

arrhythmia therapy - heart valve surgery - minimally invasive surgery


Publication History

Received: 04 March 2021

Accepted: 22 April 2021

Article published online:
14 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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