New Guidelines Recommend Surgical Ablation to Reduce Atrial Fibrillation

New clinical practice guidelines issued by the Society of Thoracic Surgeons (STS; Chicago, IL, USA) conclude that surgical ablation as a treatment option for atrial fibrillation (AF) has experienced continued development over the last 30 years, with its frequency and success steadily increasing, and as such deserves a more prominent role in adult cardiac surgery.

In developing the new guidelines, the STS writing committee assessed the safety of surgical ablation for three surgical approaches: primary open atrial operations, where the left atrium is already being opened, such as in mitral valve and/or tricuspid valve repair or replacement; primary closed atrial operations, when the left atrium would not otherwise be open, such as coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) operations; and standalone operations when the only goal is to perform surgical ablation to treat AF.

The new clinical practice guidelines offer evidence-based recommendations that include surgical ablation for AF at the time of concomitant mitral operations to restore cardiac rhythm; surgical ablation for AF at the time of concomitant isolated AVR, isolated CABG, and AVR+CABG operations to restore cardiac rhythm; and surgical ablation as a primary standalone procedure to restore cardiac rhythm for symptomatic AF that is resistant to medication or catheter ablation. More...