When carrying out cardiac surgery, surgically treat atrial fibrillation, study indicates


When carrying out cardiac surgery, surgically treat atrial fibrillation, study indicates

A recent study carried out by Northwestern Medicine researchers and reported in the Journal of Thoracic and Cardiovascular Surgery found that patients with abnormal heart rhythm (atrial fibrillation or A-fib) who have cardiac surgery, have a lower long-term survival rate than those whose hearts beat normally (in sinus rhythm). The findings also indicate that by successfully treating A-fib during previously planned cardiac surgery, surgeons can level out their patients' survival rate to that of someone who never had A-fib.

Richard Lee, MD, surgical director of the Center for Heart Rhythm Disorders at Northwestern Memorial's Bluhm Cardiovascular Institute said:

"This study indicates that atrial fibrillation should be surgically treated when a patient is undergoing another cardiac surgery procedure. By fixing two issues at once, we can improve patient outcomes."

At present, only 38% of A-fib patients receive simultaneous treatment at the time of cardiac surgery compared with 90% if patients with a history of A-fib at the Bluhm Cardiovascular Institute when undergoing cardiac surgery. Several risk factors are associated with A-fib, such as high blood pressure, heart failure, diabetes, advanced age, and heart disease. Whilst some people with A-fib have no symptoms, some are unaware they even have the condition until it is discovered during a physical examination. Those with A-fib symptoms may suffer from palpitations or a racing, irregular heartbeat, shortness of breath, chest pain or lightheadedness.

A-fib is generally not a life-threatening condition, although it is a very serious medical condition that occurs when the heart beats ineffectively and can't potentially pump sufficient amounts of blood. A-fib can, over time, lead to a higher risk of stroke, congestive heart failure and death but the condition is treatable with medications and minimally invasive procedures or surgery.

Brad Knight, MD, medical director for the Center for Heart Rhythm Disorders explained:

"Not all patients require surgery for atrial fibrillation. However, this study suggests that it should be strongly considered when the patient is already undergoing another cardiac surgery procedure, as addressing both issues simultaneously may positively impact long-term heart health."

He stresses that patients with complex heart rhythm disorders like A-fib should be evaluated by an experienced heart rhythm specialist, who can offer patients various treatment options, such as heart surgery.

Surgeons treat A-fib with an ablation procedure that has proven effective and safe. Results demonstrate no differences in mortality rates at 1, 3 and 5-years between two groups of patients, with 68% of patients being free of A-fib and no longer requiring antiarrhythmic medication.

Lee concluded:

"Patients with atrial fibrillation have increased rates of stroke, heart failure and mortality. It is important to properly address the problem before it causes serious complications. By addressing it at the time of surgery, we can help patients feel better, experience fewer symptoms and increase their life expectancy in a safe way that doesn't add any risk to the operation when performed by an experienced surgeon."

Ask The Expert: Concomitant Atrial Fibrillation & Heart Valve Surgery with Dr. Jonathan Philpott (Video Medical And Professional 2020).

Section Issues On Medicine: Cardiology