Portal de Periódicos da CAPES

Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation

2019; Elsevier BV; Volume: 73; Issue: 19 Linguagem: Inglês

10.1016/j.jacc.2019.02.062

1558-3597

Joseph J. DeRose, Donna Mancini, Helena Chang, Michael Argenziano, François Dagenais, Gorav Ailawadi, Louis P. Perrault, Michael K. Parides, Wendy C. Taddei‐Peters, Michael J. Mack, Donald D. Glower, Babatunde A. Yerokun, Pavan Atluri, John C. Mullen, John D. Puskas, Karen O’Sullivan, Nancy M. Sledz, Hugo Tremblay, Ellen Moquete, Bart S. Ferket, Alan J. Moskowitz, Alexander Iribarne, Annetine C. Gelijns, Patrick T. O’Gara, Eugene H. Blackstone, A. Marc Gillinov, Marissa A. Miller, Wendy C. Taddei‐Peters, Dennis Buxton, A. Connolly, Nancy L. Geller, David Gordon, Neal Jeffries, Albert Lee, Claudia S. Moy, Ilana Kogan Gombos, Jennifer Ralph, Richard D. Weisel, Timothy J. Gardner, Patrick T. O’Gara, Eric A. Rose, Annetine C. Gelijns, Michael K. Parides, Deborah D. Ascheim, Alan J. Moskowitz, Emilia Bagiella, Ellen Moquete, Helena Chang, Melissa Chase, Edlira Dobrev, Seth Goldfarb, Lopa Gupta, Katherine Kirkwood, Ron Levitan, Karen O’Sullivan, Jessica Overbey, Milerva Santos, Michael Weglinski, Paula Williams, Carrie A. Wood, Xia Ye, Michael J. Mack, Tracine Adame, Natalie Settele, Jenny Adams, William H. Ryan, Robert L. Smith, Paul Grayburn, Frederick Y. Chen, Anju Nohria, Lawrence Cohn, Prem Shekar, Sary F. Aranki, Gregory Couper, Michael Davidson, R. Morton Bolman, Anne Burgess, Debra Conboy, Ray A. Blackwell, Roger Kerzner, Michael K. Banbury, Andrea M. Squire, A. Marc Gillinov, Eugene H. Blackstone, Bruce W. Lytle, Tomislav Meštrović, Pamela Lackner, Leoma Berroteran, Diana Dolney, Suzanne Fleming, Roberta Palumbo, Christine Whitman, Kathy Sankovic, Denise Kosty Sweeney, Gregory Pattakos, Michael Argenziano, Mathew Williams, Lyn Goldsmith, Craig R. Smith, Yoshifumi Naka, Allan Stewart, Allan Schwartz, Daniel Bell, Danielle Van Patten, S. Sreekanth, Peter K. Smith, John H. Alexander, Carmelo A. Milano, Donald D. Glower, Joseph P. Mathew, J. Kevin Harrison, Stacey Welsh, T. Bruce Ferguson, Alan P. Kypson, Evelio Rodríguez, Malissa Harris, Brenda Akers, Allison O'Neal, John D. Puskas, Vinod H. Thourani, Robert Guyton, Jefferson Baer, Kim T. Baio, Alexis A. Neill, Pierre Voisine, Mario Sénéchal, François Dagenais, Kim O’Connor, Gladys Dussault, Tatiana Ballivian, Suzanne Keilani, Robert E. Michler, David A. D’Alessandro, Joseph J. DeRose, Daniel J. Goldstein, Ricardo Bello, William Jakobleff, Mario Garcia, Cynthia Taub, Daniel M. Spevack, Roger Swayze, Nadia Sookraj, Louis P. Perrault, Arsène-Joseph Basmadjian, Denis Bouchard, Michel Carrier, Raymond Cartier, Michel Pellerin, Jean François Tanguay, Ismael El‐Hamamsy, André Denault, Jonathan Lacharité, Sophie Robichaud, David Adams, Robin Varghese, Yael Mandel-Portnoy, Keith J. Horvath, Philip C. Corcoran, Michael Siegenthaler, Mandy Murphy, Margaret Iraola, Ann Greenberg, C.B. Sai-Sudhakar, Ayseha Hasan, Asia McDavid, Bradley Kinn, John C. Mullen, Jonathan Choy, Steven Meyer, Emily Kuurstra, James S. Gammie, Christopher R. deFilippi, Dino T. Gaetani, Cindi A. Young, Dana Beach, Julia Collins, Steven F. Bolling, Francis D. Pagani, Cathie Bloem, Michael A. Acker, Y. Joseph Woo, Mary Lou Mayer, Joseph E. Bavaria, Wilson Y. Szeto, Kenneth B. Margulies, Martin Keane, Helene Glassberg, Dinesh Jagasia, James N. Kirkpatrick, Irving L. Kron, Gorav Ailawadi, Karen C. Johnston, John Dent, John A. Kern, Jessica Keim‐Malpass, Sandra G. Burks, Kim Gahring, Abeel A. Mangi, Joseph G. Akar, David D. Yuh, Lynn Wilson, David A. Bull, Patrice Desvigne‐Nickens, Dennis O. Dixon, Mark C. Haigney, Richard Holubkov, Alice Jacobs, Frank E. Miller, John M. Murkin, John A. Spertus, Andrew S. Wechsler, Frank W. Sellke, Cheryl L. McDonald, Robert Byington, Neal W. Dickert, Dennis O. Dixon, John S. Ikonomidis, David O. Williams, Clyde W. Yancy, John M. Canty, James C. Fang, Nadia Giannetti, Wayne Richenbacher, Vivek Rao, Karen L. Furie, Rachel Miller, Sean Pinney, William C. Roberts, Mary Norine Walsh, Judy Hung, Xin Zeng, Jean‐Philippe Couderc, Dan Balda, Wayne D. Bowen, Mauri Wilson, Anne Schering,

Cardiac pacing and defibrillation studies

The incidence of permanent pacemaker (PPM) implantation is higher following mitral valve surgery (MVS) with ablation for atrial fibrillation (AF) compared with MVS alone. This study identified risk factors and outcomes associated with PPM implantation in a randomized trial that evaluated ablation for AF in patients who underwent MVS. A total of 243 patients with AF and without previous PPM placement were randomly assigned to MVS alone (n = 117) or MVS + ablation (n = 126). Patients in the ablation group were further randomized to pulmonary vein isolation (PVI) (n = 62) or the biatrial maze procedure (n = 64). Using competing risk models, this study examined the association among PPM and baseline and operative risk factors, and the effect of PPM on time to discharge, readmissions, and 1-year mortality. Thirty-five patients received a PPM within the first year (14.4%), 29 (83%) underwent implantation during the index hospitalization. The frequency of PPM implantation was 7.7% in patients randomized to MVS alone, 16.1% in MVS + PVI, and 25% in MVS + biatrial maze. The indications for PPM were similar among patients who underwent MVS with and without ablation. Ablation, multivalve surgery, and New York Heart Association functional (NYHA) functional class III/IV were independent risk factors for PPM implantation. Length of stay post-surgery was longer in patients who received PPMs, but it was not significant when adjusted for randomization assignment (MVS vs. ablation) and age (hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.61 to 1.08; p = 0.14). PPM implantation did not increase 30-day readmission rate (HR: 1.43; 95% CI: 0.50 to 4.05; p = 0.50). The need for PPM was associated with a higher risk of 1-year mortality (HR: 3.21; 95% CI: 1.01 to 10.17; p = 0.05) after adjustment for randomization assignment, age, and NYHA functional class. AF ablation, multivalve surgery, and NYHA functional class III/IV were associated with an increased risk for permanent pacing. PPM implantation following MVS was associated with a significant increase in 1-year mortality. (Surgical Ablation Versus No Surgical Ablation for Patients With Atrial Fibrillation Undergoing Mitral Valve Surgery; NCT00903370)