Conclusion
The stand-alone CMP-IV had superior 5 and 7 year recurrence-free
survival rates for patients with longstanding persistent AF compared to
published reports of other surgical and catheter-based ablation
techniques. The stand-alone CMP-IV was equally effective regardless of
surgical approach, or number of previous catheter ablations. There were
no mortalities and the rate of morbidity was low. On Fine-Gray
regression, preoperative time in AF and early postoperative ATAs were
predictive of late ATAs recurrence. Based on these findings, we
recommend consideration of stand-alone CMP-IV for symptomatic patients
with longstanding persistent AF who have failed catheter ablation or are
poor candidates for catheter-based therapies.