Background: Radiofrequency ablation therapy for the treatment of atrial fibrillation (AF) can be performed as a concomitant procedure alongside cardiac surgery, but carries the risks of increased bypass time and damage to the sinoatrial node. This study aims to assess the efficacy of concomitant surgical AF ablation and develop a novel scoring system to predict post-procedural return to sinus rhythm.

Methods: Ablation (n=53) and control (n=36) groups were retrospectively selected from the Leeds General Infirmary surgical database. Follow-up was obtained using patient notes, clinic letters and echocardiographic data. Primary outcome was freedom from AF at median follow up (ablation group=383 days, control group=317 days). A novel scoring system was created through analysis of previous literature and evaluated using a receiver operating characteristic (ROC) curve.

Results: A larger proportion of the ablation group was free from AF at median follow up when compared to controls (50.9% vs. 2.8% respectively, p = <0.001). The novel scoring system was shown to predict post-procedural return to sinus rhythm (ROC AUC = 0.7708).

Conclusion: Addition of a concomitant ablation procedure significantly increases levels of return to sinus rhythm in patients undergoing cardiac surgery. A novel scoring system was shown to adequately predict procedural success. These results can be further validated using larger patient cohorts.