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\begin{document}

\title{Effect of Concomitant Surgical Atrial Fibrillation Ablation in Patients
with Reduced Left Ventricle Ejection Fraction: A Propensity-Score
Matching Analysis}



\author[1]{Goran Rimac}%
\author[1]{Nicolas Lauzon}%
\author[1]{Mario Sénéchal}%
\author[1]{François Dagenais}%
\author[1]{Frederic Jacques}%
\author[1]{François Philippon}%
\author[1]{Pierre Voisine}%
\affil[1]{Institut universitaire de cardiologie et de pneumologie de Quebec}%


\vspace{-1em}



  
  \date{May 18, 2024}


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\begin{abstract}
Background: Atrial fibrillation (AF) is common in patients with reduced
left ventricle ejection fraction (RLVEF). The impact of concomitant
surgical atrial fibrillation ablation (SAFA) in patients with RLVEF is
uncertain. The purpose of this study was to assess the outcomes of
concomitant SAFA in patients with RLVEF undergoing heart surgery on
heart failure (HF) rehospitalization and mortality. Methods: Using a
local registry and electronic health records linked with provincial
civil register survival data from July 2002 to April 2019, we analyzed
treatment and outcomes in a cohort of patients with AF and HF defined by
left ventricle ejection fraction (LVEF) [?] 40\%. Health records were used
to collect treatment and International Classification of Diseases (ICD
10) codes to determine outcomes. A negative binomial model was used to
compare outcomes such as all-cause mortality and rehospitalization for
heart failure. Results: The cohort included 682 patients with RLVEF and
AF who underwent coronary artery bypass graft and/or valve surgery. A
total of 196 patients (29\%) underwent concomitant SAFA. After matching,
132 patients with concomitant SAFA were compared to 159 patients who did
not undergo concomitant SAFA. At 6.0\selectlanguage{ngerman}±3.7 years of follow-up, concomitant
SAFA was not associated with lower all-cause mortality (P=0.9861) and
reduction in rehospitalizations for heart failure decompensation
(P=0.31) compared to patients who did not have concomitant SAFA
performed. Post-operatively, concomitant SAFA might be associated with
less vasopressor and mechanical support use (p=0.01). Conclusions:
Concomitant SAFA during index cardiac surgery is safe but does not
reduce mortality or rehospitalizations for HF. The effects of
concomitant SAFA in the context of RLVEF needs to be better studied with
prospective trials.%
\end{abstract}\selectlanguage{ngerman}%



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