On the basis of the evidence presented in this systematic review, The ASERNIP-S Review Group agreed on the following classifications and recommendations concerning the safety and efficacy of intraoperative ablation for the treatment of AF:
Classification: Evidence rating - The available evidence was assessed as being poor.
Safety - There was insufficient evidence to determine if intraoperative ablation was more or less safe than cardiac surgery alone, or the Maze-III procedure. Associated risks relating to longer bypass times, plus the possibility of oesophageal perforation and circumflex artery injuries, are potential concerns. There were no studies comparing intraoperative ablation with medical management of AF, therefore safety could not be evaluated.
Efficacy - Intraoperative ablation is at least as efficacious as cardiac surgery alone, or the Maze-III procedure. There were no studies comparing intraoperative ablation with medical management of AF, therefore efficacy could not be evaluated.