Improved Long-Term Survival with Atrial Fibrillation Ablation during CABG

According to a June 4 press release, a new study, published in The Annals of Thoracic Surgery, used Medicare data and found that patients with preexisting atrial fibrillation (AF) who undergo surgical ablation at the time of coronary artery bypass grafting (CABG) experience significantly improved long-term survival.

Research presented by the Society of Thoracic Surgeons analyzed outcomes from approximately 88,000 patients between 2008 and 2019. Of those, only 22% received ablation during their CABG procedure, despite a Class I guideline recommendation issued in 2017 that supports the combined approach. Patients who received ablation lived, on average, 4.4 months longer than those who did not, with survival rising from 7.46 to 7.82 years.

Further, the study also found that when ablation was performed by surgeons who regularly used the technique, survival increased by nearly five months. Importantly, the survival benefit did not become evident until more than two years after surgery, suggesting that the procedure may reduce complications like heart failure associated with rapid or irregular heart rhythms. Researchers used advanced statistical methods—including overlap propensity score weighting and instrumental variable analysis—to ensure the findings accounted for differences in patient health and surgical expertise. Despite the proven benefits, the data highlights a persistent underuse of surgical ablation during CABG, underscoring the need for broader adoption of the guideline-backed practice.