LONG-TERM FOLLOW-UP OF CORRIDOR OPERATION FOR LONE ATRIAL-FIBRILLATION - EVIDENCE FOR PROGRESSION OF DISEASE

Introduction: Currently, surgery-and catheter-mediated ablation is app lied when drug refractoriness of atrial fibrillation is evident, altho ugh little is known about the long-term incidence of new atrial arrhyt hmia and the preservation of sinus node function, Methods ann Results: To address this issue, 30 patients with successful corridor surgery f or lone paroxysmal atrial fibrillation and normal preoperative sinus n ode function were followed in a single outpatient department. Five yea rs after surgery, the actuarial proportion of patients with recurrence of atrial fibrillation arising in the corridor was 8% +/- 5%, with ne w atrial arrhythmias consisting of atrial flutter and atrial tachycard ia in the corridor 27% +/- 8%, and with incompetent sinus node requiri ng pacing therapy 13% +/- 6%, Right atrial transport was preserved in 69% of the patients without recurrence of atrial fibrillation and norm al sinus node function, Stroke was documented in two patients, Conclus ions: Corridor surgery for atrial fibrillation is a transient or palli ative treatment instead of a definitive therapy for drug refractory at rial fibrillation, This observation strongly affects patient selection for this intervention and constitutes a word of caution for other, no npharmacologic interventions for drug refractory atrial fibrillation.