{"id":"55d5c6c81216","type":"article","url":"https://hartvaat.nl/2026/11/01/concomitante-chirurgische-af-behandeling-tijdens-cabg-verbetert-langetermijnover/","title":"Concomitante chirurgische AF-behandeling tijdens CABG verbetert langetermijnoverleving","title_en":"Atrial fibrillation in coronary artery bypass patients: what should be offered.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Current opinion in cardiology","doi":"10.1097/HCO.0000000000001334","source_url":"https://doi.org/10.1097/HCO.0000000000001334","authors":["Adam Eqbal","Emilie Belley-Cote","Richard Whitlock"],"significance":5,"published":"2026-10-08","source_date":"2026-11-01","image":"https://hartvaat.nl/global/img/6e2cc0469790.webp","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-en-beroerte/","https://hartvaat.nl/kennis/atriumfibrilleren/ecg-herkenning-af/"],"congress":"","summary_en":"Among patients undergoing coronary artery bypass grafting (CABG), 10-20% have pre-existing atrial fibrillation (AF) that is frequently undertreated during surgery. This narrative review highlights that concomitant surgical AF management—ranging from left atrial appendage occlusion to full Cox-maze ablation—can be safely integrated without increasing perioperative risk. Large observational studies indicate that this approach improves long-term rhythm control, survival, and stroke risk. For cardiac surgeons and cardiologists, the findings support a tailored, more proactive strategy for AF during CABG, pending confirmation from randomized trials.","created":"2026-10-02T00:53:01Z","updated":"2026-10-02T00:53:03Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Van de patiënten die een CABG ondergaan, heeft 10-20% voorafgaand atriumfibrilleren (AF), dat vaak niet adequaat wordt behandeld tijdens de operatie. Deze narrative review toont aan dat concomitante chirurgische AF-behandeling, variërend van linkervoorhoofdkamerappendage-occlusie tot een volledige Cox-maze, zonder extra perioperatief risico kan worden uitgevoerd. Observatiedata suggereren dat deze aanpak het ritme verbetert en langetermijnoverleving verhoogt met een lager beroertecijfer. Voor cardiologen en hartchirurgen betekent dit dat een op maat gemaakte, proactieve aanpak van AF tijdens CABG overwogen moet worden, ondanks het huidige gebrek aan robuuste RCT's.","abstract_original":"PURPOSE OF REVIEW: Of patients undergoing coronary artery bypass grafting (CABG), 10-20% have preexisting atrial fibrillation (AF), which remains undertreated at the time of surgery. With rapidly evolving data, interest and enthusiasm for concomitant surgical management of AF have grown concurrently. This review summarizes the contemporary evidence, techniques, and approaches for surgical management of AF in patients undergoing CABG and proposes tailored operative strategies for these patients at the time of surgery. RECENT FINDINGS: Concomitant surgical management of AF at the time of CABG is underutilized, with only 30-40% of eligible patients receiving concomitant AF treatment. Surgeons can offer a spectrum of options to concurrently treat AF, from left atrial appendage occlusion (LAAO) to a full biatrial Cox-maze iteration without significant additional perioperative risk. Contemporary large-scale observational analyses suggest concomitant surgical ablation improves rhythm outcomes and is associated with improved survival, and lower risk of stroke long-term. SUMMARY: Concomitant LAAO is essential. Ablation techniques can be tailored based on the patient's burden of AF, clinical complexity, and surgeon expertise. A robust randomized trial is needed to convince clinicians to expand adoption."}