{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T04:17:29Z","timestamp":1754108249962,"version":"3.37.3"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"name":"The Rusche grant of the German Society of Thoracic and Cardiovascular Surgery (DGTHG) and the German Heart Foundation"},{"name":"UKGM research funding"},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["Projektnummer 268555672\u2013SFB 1213"],"award-info":[{"award-number":["Projektnummer 268555672\u2013SFB 1213"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["Project B03 and B06"],"award-info":[{"award-number":["Project B03 and B06"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Although concomitant surgical ablation can help to reach freedom from atrial fibrillation (FREEAF) even in patients with permanent atrial fibrillation (AF), some cardiac surgeons hesitate to perform concomitant ablation to avoid perioperative risk escalation. Here, we investigated outcome and predicators of therapeutic success of concomitant surgical ablation in an all-comers study.<\/jats:p><jats:p>\n          Methods\u2003Ablation-na\u00efve patients with formerly accepted permanent AF (FAP, n\u2009=\u200941) or paroxysmal AF (parAF, n\u2009=\u200924) underwent concomitant epicardial bipolar radio frequency ablation and implantable loop recorder (ILR) at two surgical departments. Follow-up examination for 24 months included electrocardiogram, ILR readout, 24h Holter monitoring, echocardiography, and blood sampling.<\/jats:p><jats:p>\n          Results\u2003Eighty-six percent of parAF and 70% of FAP patients reached FREEAF (month 24). Mortality was low (parAF\/FAP: 5.3\u2009\u00b1\u20090.2%\/4.1\u2009\u00b1\u20090.3%; p\u2009&lt;\u20090.05; EuroScoreII; 6.1\u2009\u00b1\u20090.7%\/6.4\u2009\u00b1\u20090.4%, p\u2009=\u2009ns) and no strokes occurred. FREEAF induced atrial reverse remodeling (left atrial [LA] diameter: \u22126.7\u2009\u00b1\u20092.2\u2009mm) and improved cardiac function (left ventricular ejection fraction [LVEF]: +7.3\u2009\u00b1\u20092.8%), while AF resulted in further atrial dilation (+8.0\u2009\u00b1\u20091.0\u2009mm, p\u2009&lt;\u20090.05) and LVEF reduction (\u22127.0\u2009\u00b1\u20091.3%, p\u2009&lt;\u20090.05). Higher LV (odds ratio [OR]: 1.164) and LA diameter (OR: 1.218), age (OR: 1.180) and body mass index (BMI) (OR: 1.503) increased the risk factors of AF recurrence. Patients remaining in sinus rhythm (SR) demonstrated a decrease in BMI, while AF recurrence was associated with stable overweight. Further aging did not reduce FREEAF.<\/jats:p><jats:p>\n          Conclusions\u2003Long-term SR is achievable by concomitant surgical ablation even in FAP patients. Therefore, it should be offered routinely. Obesity influences therapeutic long-term success but may also offer addressable therapeutic targets to reach higher FREEAF rates.<\/jats:p>","DOI":"10.1055\/s-0041-1731772","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T22:49:52Z","timestamp":1631659792000},"page":"264-272","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Ablation of Permanent Atrial Fibrillation: Age, LV Dilatation, Obesity"],"prefix":"10.1055","volume":"71","author":[{"given":"Susanne","family":"Rohrbach","sequence":"first","affiliation":[{"name":"Institute of Physiology, Justus Liebig University Giessen, Hessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Dominik","sequence":"first","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital of Giessen and Marburg, Giessen and Justus-Liebig-University Giessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolas","family":"Mirow","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital of Giessen and Marburg, Marburg Philipps University Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Vogt","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital of Giessen and Marburg, Marburg Philipps University Marburg, Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"B\u00f6ning","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital of Giessen and Marburg, Giessen and Justus-Liebig-University Giessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Niemann","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Hospital of Giessen and Marburg, Giessen and Justus-Liebig-University Giessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/S0140-6736(14)61774-8","article-title":"50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study","volume":"386","author":"R B Schnabel","year":"2015","journal-title":"Lancet"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/j.ijcard.2012.12.093","article-title":"Atrial fibrillation: profile and burden of an evolving epidemic in the 21st 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