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Top 7 Reasons
To Treat AFib

Top 7 Reasons To Treat AFib


Atrial fibrillation (AFib) is the most common type of heart arrhythmia worldwide. In the United States, AFib prevalence is projected to increase 300% to 12.1 million patients by the year 2030, according to the Amercian Heart Association. Here are seven important reasons for surgeons to use surgical ablation to treat AFib patients.

  1. Increases mid- and long-term survival of patients. According to the European Journal of Cardio-Thoracic Surgery, patient survival improves by 42% one year after coronary artery bypass graft (CABG) surgery with surgical ablation for AFib. Ten years after CABG surgery, AFib patients who receive a Cox Maze-IV procedure (CM4) – performed concomitantly with other cardiac procedures – show a 20% improvement in survival rate, this according to a study by the Division of Cardiothoracic Surgery, Washington University School of Medicine in St. Louis.
  1. Improves patients’ quality of life. Patients who are not treated for intermittent or chronic AFib see a decrease in general and mental health according to the Division of Cardiac Surgery at the University of Rome, a decrease in cognitive impairment, including dementia and Alzheimer's disease – per The Rotterdam Study – and an increase in doctor visits – 12 hospital outpatient visits and 67 physician encounters on average – according to an Avalere Health study. The Anatolian Journal of Cardiology reports that the subjective health-related quality of life is worse in patients with intermittent AFib.

  2. Decreases the risk of stroke and heart disease. The risk of having stroke in patients with chronic, recurring AFib is four times the rate of patients who have treated their AFib, according to the American Journal of Cardiology. A study published by the British Journal of Medicine, showed an increased risk of cardiovascular diseases and renal disease. The rate of heart disease in their study increases five-fold in patients with recurring, untreated AFib.
  1. Helps extend a patient’s life: AFib is deadly. According to the National Heart, Lung, and Blood Institute’s Framingham Heart Study, among men between the ages of 55 and 74, the 10-year mortality rate was 61.5% in men with AFib versus 30% in men without AFib. Among women in a similar age group, the 10-year mortality rate was 57.6% with AFib compared to 20.9% in women without AFib. In a study published by the European Heart Journal, across patients over 65 with AFib, the mortality rate was 19.5% at one year and 48.8% at five years.

  2. Keeps patient costs down: AFib is expensive. According to the Centers for Disease Control and Prevention, medical costs for patients AFib are about $8,700 higher per year than for people who do not have AFib. The CDC estimates that AFib costs the U.S. health care system $6 billion per year, while the American Heart Association approximates the cost in upwards of $26 billion per year.

  3. AFib Treatment works. While AFib is often surgically under-treated, treatment and diagnosis are highly effective. The Cox Maze-IV procedure – a common approach for surgical treatment of AFib – indicated 90% of patients free from AFib and 84% free from AFib and off antiarrhythmic drugs after two years in a study published by the Journal of Interventional Cardiac Electrophysiology. Ten years after surgery, 80% of patients were free from symptomatic AFib and any antiarrhythmic drugs.

  4. The Society of Thoracic Surgeons (STS) Recommends Surgical Ablation. In 2017, the STS recommended the surgical treatment of atrial fibrillation for concomitant mitral operations (Class I, Level A) and isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations (Class I, Level B nonrandomized).  To see the STS Clinical Practice Guidelines for Surgical Treatment of AFib, click here.

Atrial fibrillation (AFib) is the most common type of heart arrhythmia worldwide. In the United States, AFib prevalence is projected to increase 300% to 12.1 million patients by the year 2030, according to the American Heart Association. Here are seven important reasons for surgeons to use surgical ablation to treat AFib patients.

  1. Increases mid- and long-term survival of patients. According to the European Journal of Cardio-Thoracic Surgery, patient survival improves by 42% one year after coronary artery bypass graft (CABG) surgery with surgical ablation for AFib. Ten years after CABG surgery, AFib patients who receive a Cox Maze-IV procedure (CM4) – performed concomitantly with other cardiac procedures – show a 20% improvement in survival rate, this according to a study by the Division of Cardiothoracic Surgery, Washington University School of Medicine in St. Louis.
  1. Improves patients’ quality of life. Patients who are not treated for intermittent or chronic AFib see a decrease in general and mental health according to the Division of Cardiac Surgery at the University of Rome, a decrease in cognitive impairment, including dementia and Alzheimer's disease – per The Rotterdam Study – and an increase in doctor visits – 12 hospital outpatient visits and 67 physician encounters on average – according to an Avalere Health study. The Anatolian Journal of Cardiology reports that the subjective health-related quality of life is worse in patients with intermittent AFib.

  2. Decreases the risk of stroke and heart disease. The risk of having stroke in patients with chronic, recurring AFib is four times the rate of patients who have treated their AFib, according to the American Journal of Cardiology. A study published by the British Journal of Medicine, showed an increased risk of cardiovascular diseases and renal disease. The rate of heart disease in their study increases five-fold in patients with recurring, untreated AFib.
  1. Helps extend a patient’s life: AFib is deadly. According to the National Heart, Lung, and Blood Institute’s Framingham Heart Study, among men between the ages of 55 and 74, the 10-year mortality rate was 61.5% in men with AFib versus 30% in men without AFib. Among women in a similar age group, the 10-year mortality rate was 57.6% with AFib compared to 20.9% in women without AFib. In a study published by the European Heart Journal, across patients over 65 with AFib, the mortality rate was 19.5% at one year and 48.8% at five years.

  2. Keeps patient costs down: AFib is expensive. According to the Centers for Disease Control and Prevention, medical costs for patients AFib are about $8,700 higher per year than for people who do not have AFib. The CDC estimates that AFib costs the U.S. health care system $6 billion per year, while the American Heart Association approximates the cost in upwards of $26 billion per year.

  3. AFib Treatment works. While AFib is often surgically under-treated, treatment and diagnosis are highly effective. The Cox Maze-IV procedure – a common approach for surgical treatment of AFib – indicated 90% of patients free from AFib and 84% free from AFib and off antiarrhythmic drugs after two years in a study published by the Journal of Interventional Cardiac Electrophysiology. Ten years after surgery, 80% of patients were free from symptomatic AFib and any antiarrhythmic drugs.

  4. The Society of Thoracic Surgeons (STS) Recommends Surgical Ablation. In 2017, the STS recommended the surgical treatment of atrial fibrillation for concomitant mitral operations (Class I, Level A) and isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations (Class I, Level B nonrandomized).  To see the STS Clinical Practice Guidelines for Surgical Treatment of AFib, click here.

References

Colilla, S. et al. (2013). Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol, 112(8):1142-7.
https://www.ncbi.nlm.nih.gov/pubmed/23831166

Rankin, J.S., Lerner, D.J., Braid-Forbes, M.J., Ferguson, M.A., & Badhwar, V. (2017). One-year mortality and costs associated with surgical ablation for atrial fibrillation concomitant to coronary artery bypass grafting. Eur J Cardiothorac Surg, 52(3):471-7.
https://www.ncbi.nlm.nih.gov/pubmed/28472412

Illustrated techniques for performing the Cox-Maze IV procedure through a right mini-thoracotomy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904342/

Musharbash, F.N. et al. (2018). Performance of the Cox-maze IV procedure is associated with improved long-term survival in patients with atrial fibrillation undergoing cardiac surgery. J Thorac Cardiovasc Surg, 155(1):159-70.
https://www.jtcvs.org/article/S0022-5223(17)32137-2/fulltext

Forlani, S. et al. (2006). Conversion to Sinus Rhythm by Ablation Improves Quality of Life in Patients Submitted to Mitral Valve Surgery. Ann of Thorac Surg, 81(3):863-7.
https://www.annalsthoracicsurgery.org/article/S0003-4975(05)01596-1/pdf

Ott, A. et al. (1997). Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke, 28(2): 316-21.
https://www.ncbi.nlm.nih.gov/pubmed/9040682

Sullivan, E., Braithwaite, S., Dietz, K., & Hickey, C. (2010). Health services utilization and medical costs among Medicare atrial fibrillation patients. Avalere Health, 4(2):7.
https://avalere.com/research/docs/Avalere-AFIB_Report-09212010.pdf

Nazli, C. et al. (2016). Impaired quality of life in patients with intermittent atrial fibrillation. Anatol J Cardiol, 16(4): 250-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368434/

Odutayo, A. et al. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ; 354: i4482.
https://www.bmj.com/content/354/bmj.i4482

Impact of Atrial Fibrillation on the Risk of Death The Framingham Heart Study Emelia J. Benjamin, MD, ScM; Philip A. Wolf, MD; Ralph B. D’Agostino, PhD; Halit Silbershatz, PhD; William B. Kannel, MD; Daniel Levy, MD
https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.98.10.946

Eur Heart J. 2014 Jan;35(4):250-6. doi: 10.1093/eurheartj/eht483. Epub 2013 Nov 25.
Clinical course of atrial fibrillation in older adults: the importance of cardiovascular events beyond stroke.
https://academic.oup.com/eurheartj/article/35/4/250/466888

Kim, M.H., Johnston, S.S., Chu, B.C., Dalal, M.R., & Schulman, K.L. (2011). Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes, 4(3):313-20.
https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.110.958165

Centers for Disease Control and Prevention. (2017). Atrial Fibrillation Fact Sheet. Accessed Dec 2018.
https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm

Weimar, T. et al. (2011). The Cox-maze IV procedure for lone atrial fibrillation: a single center experience in 100 consecutive patients. J Interv Card Electrophysiol. 31(1):47-54.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332766/

Page last updated: July 1, 2019

Page created: February 7, 2019

References

Colilla, S. et al. (2013). Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol, 112(8):1142-7.
https://www.ncbi.nlm.nih.gov/pubmed/23831166

Rankin, J.S., Lerner, D.J., Braid-Forbes, M.J., Ferguson, M.A., & Badhwar, V. (2017). One-year mortality and costs associated with surgical ablation for atrial fibrillation concomitant to coronary artery bypass grafting. Eur J Cardiothorac Surg, 52(3):471-7.
https://www.ncbi.nlm.nih.gov/pubmed/28472412

Illustrated techniques for performing the Cox-Maze IV procedure through a right mini-thoracotomy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904342/

Musharbash, F.N. et al. (2018). Performance of the Cox-maze IV procedure is associated with improved long-term survival in patients with atrial fibrillation undergoing cardiac surgery. J Thorac Cardiovasc Surg, 155(1):159-70.
https://www.jtcvs.org/article/S0022-5223(17)32137-2/fulltext

Forlani, S. et al. (2006). Conversion to Sinus Rhythm by Ablation Improves Quality of Life in Patients Submitted to Mitral Valve Surgery. Ann of Thorac Surg, 81(3):863-7.
https://www.annalsthoracicsurgery.org/article/S0003-4975(05)01596-1/pdf

Ott, A. et al. (1997). Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke, 28(2): 316-21.
https://www.ncbi.nlm.nih.gov/pubmed/9040682

Sullivan, E., Braithwaite, S., Dietz, K., & Hickey, C. (2010). Health services utilization and medical costs among Medicare atrial fibrillation patients. Avalere Health, 4(2):7.
https://avalere.com/research/docs/Avalere-AFIB_Report-09212010.pdf

Nazli, C. et al. (2016). Impaired quality of life in patients with intermittent atrial fibrillation. Anatol J Cardiol, 16(4): 250-5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368434/

Odutayo, A. et al. (2016). Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ; 354: i4482.
https://www.bmj.com/content/354/bmj.i4482

Impact of Atrial Fibrillation on the Risk of Death The Framingham Heart Study Emelia J. Benjamin, MD, ScM; Philip A. Wolf, MD; Ralph B. D’Agostino, PhD; Halit Silbershatz, PhD; William B. Kannel, MD; Daniel Levy, MD
https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.98.10.946

Eur Heart J. 2014 Jan;35(4):250-6. doi: 10.1093/eurheartj/eht483. Epub 2013 Nov 25.
Clinical course of atrial fibrillation in older adults: the importance of cardiovascular events beyond stroke.
https://academic.oup.com/eurheartj/article/35/4/250/466888

Kim, M.H., Johnston, S.S., Chu, B.C., Dalal, M.R., & Schulman, K.L. (2011). Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes, 4(3):313-20.
https://www.ahajournals.org/doi/full/10.1161/CIRCOUTCOMES.110.958165

Centers for Disease Control and Prevention. (2017). Atrial Fibrillation Fact Sheet. Accessed Dec 2018.
https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm

Weimar, T. et al. (2011). The Cox-maze IV procedure for lone atrial fibrillation: a single center experience in 100 consecutive patients. J Interv Card Electrophysiol. 31(1):47-54.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332766/

Page last updated: July 1, 2019