Do Something – ACT against Afib

Do Something.

Surgical Ablation Guidelines are Advancing

Surgical-Ablation-Historical-Guidelines

Cox Maze IV yields the highest efficacy for Afib treatment, but literature shows progressive efficacy for each additive lesion set of Cox Maze IV

COR: Class of Recommendation
LOE: Level of Evidence
+IIa B in 2020
‡ First guideline for Hybrid Ablation in 2017

Sources:

+Article in Press. https://www.heartrhythmjournal.com/article/S1547-5271(24)00261-3/fulltext (accessed 4/10/2024). Heart Rhythm Society, the European Society of Cardiology, the Asia Pacific Heart Rhythm Society, and the Latin American
Heart Rhythm Society 2024. +Hybrid ablation type of evidence META (meta-analysis); LAAE type of evidence RAND (randomized controlled); nomenclature did not use LOE classification. ^Advice TO DO/RAND. †Advice TO DO/META.
Wyler von Ballmoos, M.C. et al. (2024). The Society of Thoracic Surgeons 2023 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation.
Members, W. C., et al. (2023). 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice
Guidelines. Journal of the American College of Cardiology.
January, C. T., et al. (2019). 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task
Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, CIR-0000000000000665.
Badhwar, et al. (2017). The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation. Ann Thorac Surg, 103(1):329-41. ‡MVR LOE A; AVR,CABG LOE B.
January, C.T., et al. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart
Rhythm Society. J Am Coll Cardiol, 64(21):e1-76.
*Calkins, H., et al. (2017). 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm, 14(10):e275-444. AVR/CABG concomitant ablation Class I LOR for
symptomatic persistent and long-standing persistent “refractory or intolerant to at least one Class 1 or 3 antiarrhythmic medication.”
Meier, B., et al. (2014). EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace, 16(10):1397-416.
Cox, J.L., et al. (1991). Dr. Cox performed first surgical ablation using maze I; Successful surgical treatment of atrial fibrillation. Review and clinical update. JAMA, 266 (14):1976-80.

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