Long-term outcomes of concomitant epicardial radiofrequency pulmonary vein isolation in patients undergoing coronary artery bypass grafting
Authors:
Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation
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Type: Original articles
DOI:
For citation: Dzhamaldinov I.A., Serguladze S.Yu., Lukashkin M.A., Bulaeva N.I., Berdibekov B.Sh., Romanchuk D.V., Danilov G.V., Golukhova E.Z. Long-term outcomes of concomitant epicardial radiofrequency pulmonary vein isolation in patients undergoing coronary artery bypass grafting. Creative Cardiology. 2026; 20 (2): 293–301 (in Russ.). DOI: 10.24022/1997-3187-2026-20-2-293-301
Received / Accepted: 11.04.2026 / 23.05.2026
Keywords: atrial fibrillation coronary artery disease coronary artery bypass grafting radiofrequency ablation pulmonary vein isolation
Abstract
Objective. To evaluate the outcomes of concomitant radiofrequency ablation (RFA) of the pulmonary vein (PV) ostia performed during coronary artery bypass grafting (CABG), and to identify predictors of atrial fibrillation (AF) recurrence during long-term follow-up.
Material and methods. This retrospective single-arm cohort study included 102 patients with coronary artery disease (CAD) and AF who underwent CABG combined with concomitant epicardial RFA of the pulmonary veins. The mean age was 66.0 ± 6.5 years; 81.3% of patients were male. The primary endpoint was late AF recurrence, defined as any documented episode of atrial tachyarrhythmia lasting 30 seconds or longer after completion of the 90-day blanking period. The median follow-up duration was 29.5 [18.0–37.0] months.
Results. In the early postoperative period, sinus rhythm was observed in 94.1% of patients and was maintained in 93.1% at discharge. During the 90-day blanking period, AF episodes were documented in 31.4% of patients. At 12 months, AF recurrence was observed in 23.5% of patients, while late AF recurrence during long-term follow-up occurred in 33.3%. According to Kaplan–Meier analysis, freedom from AF recurrence at 60 months was 64.0%. In the multivariable Cox model, persistent AF (hazard ratio [HR] 3.12; 95% confidence interval [CI] 1.07–19.21; p = 0.040) and increased transverse left atrial diameter (HR 1.15 per 1 mm; 95% CI 1.03–1.40; p = 0.027) were identified as independent predictors of late AF recurrence.
Conclusion. Concomitant epicardial radiofrequency isolation of the pulmonary vein ostia during CABG was associated with maintenance of sinus rhythm in a substantial proportion of patients during long-term follow-up and with a low rate of serious perioperative complications. Persistent AF and increased left atrial size were independent predictors of late arrhythmia recurrence.
