Page 29 - ADD-ON ABLATION SURGERY IN PATIENTS WITH ATRIAL FIBRILLATION
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enhanced exercise capacity and higher left ventricle ejection fraction in case SR
conversion was successful165-166. Although SR conversion might seem successful, 1 (a)symptomatic recurrences of AF after ablation surgery may occur in 2-16% of
patients within the first year post-surgery167-168.These recurrences are thought to
result from recovered pulmonary vein conduction and the pro-arrhythmic effects
of ablation itself. Recurrences are generally treated with antiarrhythmic drugs or cardioversion to minimize the chance of future development of heart failure but
also because of the generally accepted idea of ‘AF begets AF’169.
Aims of the thesis
The aims of the study are fourfold:
1) To assess quality of life (QoL) and cost-effectiveness of add-on surgery
(Chapters 2,4) and to explore the relationship between successful normal sinus rhythm (NSR) conversion and postoperative health-related QoL (Chapter 3).
2) To compare early and mid-term outcomes of patients who underwent electrical cardioversion (ECV) for AF recurrence following add-on surgery ablation compared to those who did not undergo concomitant AF ablation. Procedural and peri-procedural variables were also considered to determine predictors of AF recurrence (Chapter 5).
3) To investigate the real-life anticoagulation treatment after add-on ablation surgery in order to examine whether this treatment adheres to current guidelines to explore all factors related to oral anticoagulation (OAC) use preoperatively and at follow-up (Chapter 6).
4) To assess the impact of lesion set and surgical technique on long-term recurrence of AF following add-on surgery (Chapter 7).
Finally, an overview will be given to summarise and discuss results from published articles about hybrid ablation for the treatment of AF to establish the efficacy of this procedure as well as its potential superiority over catheter ablation or standard surgical technique which may represent a future step also for add-on surgery (Chapter 8).
Introduction
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