{
  "abstract": "Background Surgical ablation (SA) is a key treatment for atrial fibrillation (AF) patients undergoing heart surgery. However, direct comparisons between SA and non-mitral valve (non-MV) surgery alone are lacking. We performed a systematic review and meta-analysis comparing concomitant SA to isolated non-MV surgery in AF patients.Methods MEDLINE, Embase and Cochrane were searched. Outcomes of interest were: (1) postoperative AF (POAF); (2) early all-cause mortality; (3) postoperative pacemaker implantation and (4) stroke. Additionally, a subgroup analysis comparing randomised controlled trials (RCTs) and propensity score-matched studies (PSM) was conducted. Risk ratios (RRs) and their respective 95% CI were calculated using a random effects model.Results After screening 6423 citations, we included 2 RCTs and 5 PSM studies encompassing 39 348 AF patients undergoing non-MV surgery, of whom 18 394 (46.7%) underwent SA. Compared with isolated non-MV surgery, SA was associated with significant POAF reduction (RR: 0.73; 95% CI: 0.67 to 0.79; I 2=0%) and higher risk of postoperative pacemaker implantation (RR: 1.34; 95% CI: 1.14 to 1.57, I2=0%) compared with surgery alone. No differences were found in early all-cause mortality (RR: 0.96; 95% CI: 0.76 to 1.22; I2=65%) and postoperative stroke (RR: 1.06; 95% CI: 0.89 to 1.26; I2=0%). The subgroup analysis comparing RCTs and PSM showed significant consistency among the different designs.Conclusions In this meta-analysis, SA was associated with POAF reduction in non-MV surgery. In terms of safety, it was suggested that although no difference in early mortality and postoperative stroke was observed, SA had a higher risk of pacemaker implantation than isolated non-MV surgery.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, Faculdade Santa Marcelina, São Paulo, Brazil"
      ],
      "name": "Gabriel Scarpioni Barbosa"
    },
    {
      "affiliations": [
        "Medicine, Faculdade de Medicina do ABC, Santo André, Brazil"
      ],
      "name": "Eric Shih Katsuyama"
    },
    {
      "affiliations": [
        "Medicine, Faculdade de Medicina do ABC, Santo André, Brazil"
      ],
      "name": "Christian Ken Fukunaga"
    },
    {
      "affiliations": [
        "Department of Medicine, Albert Einstein Instituto Israelita de Ensino e Pesquisa, São Paulo, Brazil"
      ],
      "name": "Julia M Fernandes"
    },
    {
      "affiliations": [
        "Department of Medicine, Universidade Federal do Espírito Santo, Vitoria, Brazil"
      ],
      "name": "Ana Carolina C Coan"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Northwestern Medicine McHenry Hospital, McHenry, Illinois, USA"
      ],
      "name": "Yoana Palatianos"
    },
    {
      "affiliations": [
        "Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Ronaldo Correa Fabiano"
    },
    {
      "affiliations": [
        "Cardiology and Intensive Care, Albert Einstein Israelite Hospital, Sao Paulo, Brazil"
      ],
      "name": "Luciana Gioli-Pereira"
    },
    {
      "affiliations": [
        "Department of Medicine, Faculdade Santa Marcelina, São Paulo, Brazil"
      ],
      "name": "Hristo Kirov"
    },
    {
      "affiliations": [
        "Department of Medicine, Faculdade Santa Marcelina, São Paulo, Brazil"
      ],
      "name": "Torsten Doenst"
    },
    {
      "affiliations": [
        "Cardiothoracic Surgery, Jena University Hospital, Jena, Germany"
      ],
      "name": "Túlio Caldonazo"
    }
  ],
  "title": "Surgical ablation in non-mitral valve cardiac surgeries: a meta-analysis of early outcomes",
  "uid": "8df0606c-d35a-519f-b2c4-c5094a33dd89"
}