“It is recommended to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because there is a significant improvement in operative survival associated with surgical ablation. (Class I, LOE A)” “It is reasonable to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because long-term survival is unaffected or improved by surgical ablation. (Class IIa) - for no change in long-term survival (up to 1 year after surgery) (LOE A)
- for improvement in long-term survival (>1 year after surgery) (LOE B-NR)”
“It is reasonable to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because there is no increased risk of perioperative stroke/TIA (Class IIa, LOE A)” “It is reasonable to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because the incidence of late stroke/TIA is unaffected or decreased by surgical ablation. (Class IIa) - for no change in the incidence of late stroke /TIA (up to 1 year of follow-up after surgery) (LOE A)
- for reduction in incidence of late stroke/TIA (>1 year of follow-up after surgery) (LOE B-NR)”
“It is reasonable to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because the incidence of perioperative morbidity is not increased by surgical ablation. (Class IIa) - for deep sternal wound infection, pneumonia, reoperation for bleeding, and renal failure requiring dialysis (LOE A).
- for intensive care unit length of stay and total hospital length of stay (LOE B-R)
- for readmission less than 30 days and renal failure (LOE B-NR).”
“It is reasonable to choose to perform a concomitant surgical ablation procedure for patients with a history of AF over no treatment of AF because there is a significant improvement in [health related quality of life] (HRQL) and AF-related symptoms associated with surgical ablation of AF. (Class IIa) - for HRQL (LOE B-R)
- for AF related symptoms (LOE C-LD)”
“Hybrid procedures may be considered as a stand-alone procedure in patients with appropriate indications and by an experienced heart team. (Class IIb, LOE B-NR)” “It is reasonable to perform stand-alone surgical ablation for pulmonary vein isolation in patients with symptomatic paroxysmal AF and small left atria. (Class IIa, LOE B-R)” “The best evidence exists for the use of bipolar radiofrequency clamps and cryoablation devices, which have become integral parts of many procedures, including pulmonary vein isolation and the Cox-Maze IV procedure. The use of epicardial unipolar RF ablation outside of clinical trials is not recommended, because its efficacy remains questionable. “Training and education should be considered before the performance of surgical ablation, but the effectiveness of the training program is unclear. More specific research needs to be conducted because there have been limited populations evaluated. (Class I, LOE C)” |