AFib ablation during CABG improves survival

Michael Walter | June 06, 2025 | Cardiovascular Business | Cardiac Surgery

CABG coronary artery bypass grafting heart surgery

Medicare patients treated with surgical ablation for preexisting atrial fibrillation (AFib) during isolated coronary artery bypass grafting (CABG) procedures are associated with improved survival, according to a new analysis published in The Annals of Thoracic Surgery.[1]

Clinical guidelines already recommend that these procedures be performed together when applicable. However, researchers noted, it has still not become common among today’s surgeons.

The study’s authors tracked data from nearly 88,000 Medicare beneficiaries with pre-existing AFib who underwent CABG. Overall, 22.2% of CABG patients underwent concomitant surgical ablation. In addition, just 652 surgeons “frequently” performed ablation during CABG compared to the 3,027 surgeons who did so “infrequently” or “occasionally.”

After a median follow-up period of more than six years, CABG patients treated with concomitant ablation were linked to a risk-adjusted median survival advantage of 4.4 months. In addition, these patients did not face an increased risk of experiencing a stroke or transient ischemic attack.

“This study is one of several recent analyses suggesting that surgical ablation may meaningfully improve survival in patients with preexisting atrial fibrillation undergoing CABG,” lead author Justin Schaffer, MD, medical director of surgical outcomes at Baylor Scott & White – The Heart Hospital, said in a statement. “Our analysis found that the treatment effect of surgical ablation for AFib manifested late, over two years after CABG. We hypothesize this is because ablation leads to a decreased incidence of tachycardia-related heart failure, which translates to improved late survival.”

“These data underscore the importance of guideline adherence and hopefully will lead to a reevaluation of surgical decision-making for patients with AFib,” added co-author John Squiers, MD, a cardiothoracic surgery researcher at Baylor Scott & White The Heart Hospital.

The authors used two different methods—both overlap propensity score weighting and a surgeon-preference instrumental variable analysis—to minimize any risk of bias.

The full study is available here.

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Michael Walter, Managing Editor

Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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