Rules and principles of patient selection for surgical treatment of acquired heart diseases complicated by atrial fibrillation

The present article provides an overview of the latest guidelines and the principles of selecting the patients with acquired heart diseases complicated by atrial fibrillation (AF) for surgical treatment. The effectiveness of various methods of AF treatment in such patients is analyzed. The criteria for selecting patients of this group for an operation are described. The use of antiarrhythmic drugs in patients with AF is ineffective and even inappropriate in cases of valvular heart disease and coronary artery disease requiring surgical correction. Surgical treatment of the main heart pathology and concomitant AF ablation in these patients is preferable. When choosing tactics of intervention, it is necessary to consider not only the presence of the pathology itself, but also the baseline functional state of the elements of cardiac conduction system. The presence of initial sinus node dysfunction in patients with long-lasting persistent AF significantly increases the probability of pacemaker implantation and prolongs a patient’s stay in the intensive care unit.