Results The consensus panel agreed on the following statements in patients with AF undergoing cardiac surgery concomitant surgical ablation : 1 .
Improves the achievement of sinus rhythm at discharge and 1 year ( level A ) ; this effect is sustained up to 5 years ( level B ) .
2 .
3 .
Does not increase the risk of perioperative mortality ( level A ) , stroke ( level A ) , myocardial infa rct ion ( level B ) , cardiac tamponade ( level A ) , reoperative bleeding ( level A ) , esophageal injury ( level B ) , low cardiac output ( level A ) , intraaortic balloon ( level B ) , congestive heart failure ( level B ) , ejection fraction ( EF ; level B ) , pleural effusion ( level A ) , pneumonia ( level A ) , renal dysfunction ( level B ) , and mediastinitis ( level A ) .
The incidence of esophageal injury remains to be low ( level B ) .
4 .
Does not reduce mortality at 1 year ( level A ) .
5 .
6 .
Increases cardiopulmonary bypass and cross-clamp times ( level A ) , with no difference in intensive care unit and hospital length of stay ( level A ) .
Conclusions Given these evidence -based statements , the consensus panel stated that , in patients with persistent and permanent AF undergoing cardiac surgery , concomitant surgical ablation is recommended to increase incidence of sinus rhythm at short- and long-term follow-up ( class 1 , level A ) ; to reduce the risk of stroke and thromboembolic events ( class 2a , level B ) ; to improve EF ( class 2a , level A ) ; and to exercise tolerance ( class 2a , level A ) and long-term survival ( class 2a , level B )
Objective This purpose of this consensus conference was to determine whether surgical atrial fibrillation ( AF ) ablation during cardiac surgery improves clinical and re source outcomes compared with cardiac surgery alone in adults undergoing cardiac surgery for valve or coronary artery bypass grafting .
Efficacy of an additional MAZE procedure using cooled-tip radiofrequency ablation in patients with chronic atrial fibrillation and mitral valve disease. A randomized, prospective trial.
AIMS This study is the first prospect i ve r and omized trial evaluating the efficacy of an antiarrhythmic surgical procedure in patients with chronic atrial fibrillation undergoing mitral valve replacement .  METHODS AND RESULTS Thirty consecutive patients with chronic atrial fibrillation undergoing mitral valve replacement  were r and omized for an additional modified MAZE-operation using intra-operatively cooled-tip radiofrequency ablation ( group A ) or mitral valve replacement alone ( group B ) . Biatrial contraction was studied and functional capacity was evaluated in spiro-ergometry 6 months after surgery . Thirty-day mortality was 0 % in both groups . After 12 months , sinus rhythm was reinstituted significantly more often in patients of group A ( cumulative rate of sinus rhythm 0.800 ) compared to patients in group B ( 0.267 ) ( P<0.01 ) . 66.7 % of patients in sinus rhythm of group A had documented biatrial contraction . Electrocardioversion showed long-term success in only 17 % of patients in group A and 0 % in group B. Maximal aerobic uptake at the 6-month spiro-ergometry revealed no significant difference ( 9.3 vs 8.5 ml x min(-1 ) kg(-1 ) , P=0.530 ) . CONCLUSIONS A modified MAZE operation using cooled-tip radiofrequency ablation can be safely combined with mitral valve surgery and is highly effective in restoring sinus rhythm . Biatrial contraction is found in 66.7 % of patients with sinus rhythm undergoing mitral valve replacement plus the MAZE operation
Results The consensus panel agreed on the following statements in patients with AF undergoing cardiac surgery concomitant surgical ablation : 1 .
Improves the achievement of sinus rhythm at discharge and 1 year ( level A ) ; this effect is sustained up to 5 years ( level B ) .
2 .
3 .
Does not increase the risk of perioperative mortality ( level A ) , stroke ( level A ) , myocardial infa rct ion ( level B ) , cardiac tamponade ( level A ) , reoperative bleeding ( level A ) , esophageal injury ( level B ) , low cardiac output ( level A ) , intraaortic balloon ( level B ) , congestive heart failure ( level B ) , ejection fraction ( EF ; level B ) , pleural effusion ( level A ) , pneumonia ( level A ) , renal dysfunction ( level B ) , and mediastinitis ( level A ) .
The incidence of esophageal injury remains to be low ( level B ) .
4 .
Does not reduce mortality at 1 year ( level A ) .
5 .
6 .
Increases cardiopulmonary bypass and cross-clamp times ( level A ) , with no difference in intensive care unit and hospital length of stay ( level A ) .
Conclusions Given these evidence -based statements , the consensus panel stated that , in patients with persistent and permanent AF undergoing cardiac surgery , concomitant surgical ablation is recommended to increase incidence of sinus rhythm at short- and long-term follow-up ( class 1 , level A ) ; to reduce the risk of stroke and thromboembolic events ( class 2a , level B ) ; to improve EF ( class 2a , level A ) ; and to exercise tolerance ( class 2a , level A ) and long-term survival ( class 2a , level B )
Objective This purpose of this consensus conference was to determine whether surgical atrial fibrillation ( AF ) ablation during cardiac surgery improves clinical and re source outcomes compared with cardiac surgery alone in adults undergoing cardiac surgery for valve or coronary artery bypass grafting .