Concomitant Epicardial Pulmonary Vein Isolation in Patients With Atrial Fibrillation Undergoing Elective Cardiac Surgery

Concomitant Epicardial Pulmonary Vein Isolation in Patients With Atrial Fibrillation Undergoing Elective Cardiac Surgery

Recent studies demonstrated that radiofrequency isolation of the pulmonary veins (PVI) is a superior alternative to antiarrhythmic drug therapy in patients with symptomatical paroxysmal atrial fibrillation (AF). A substantial proportion of patients undergoing elective cardiac surgery also suffer from atrial fibrillation. No evidence exists if epicardial PVI is beneficial in patients with a history of AF undergoing coronary bypass surgery (CABG) for the concomitant treatment of AF. The investigators aim to establish the effectiveness of incorporating epicardial pulmonary vein isolation into elective cardiac surgery.

Inclusion Criteria:

• Patients ≥ 18 years of age
• EHRA class ≤ 2
• Documented history of paroxysmal, persistent, longstanding persistent or newly-diagnosed AF prior to admittance for cardiac surgery
• Patients will have elective coronary surgery planned Able of providing informed consent

Exclusion Criteria:

• Patients ≥70 years of age
• Pregnancy Patients with contraindications for oral anticoagulant agents
• Patients undergoing emergency operation
• Patients undergoing concomitant valve replacement
• Severely enlarged LA (>50 mm) on echocardiography
• Prior AF ablation or AF surgery