Modified maze procedure for atrial fibrillation: As an adjunct to elective cardiac surgery: Predictors of mid-term recurrence and echocardiographic follow-up

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Abstract

The radiofrequency maze procedure achieves sinus rhythm in 45%–95% of patients treated for atrial fibrillation. This retrospective study evaluates mid-term results of the radiofrequency maze—performed concomitant to elective cardiac surgery—to determine sinus-rhythm predictive factors, and describes the evolution of patients’ echocardiographic variables. From 2003 through 2011, 247 patients (mean age, 64 ± 9.5 yr) with structural heart disease (79.3% mitral disease) and atrial fibrillation underwent a concomitant radiofrequency modified maze procedure. Patients were monitored by 24-hour Holter at 3, 6, 12, and 24 months, then annually. Eighty-four mitral-valve patients underwent regular echocardiographic follow-up. Univariate and multivariate analysis for risk factors of maze failure were identified. The in-hospital mortality rate was 1.2%. During a median follow-up of 39.4 months, the late mortality rate was 3.6%, and pacemaker insertion was necessary in 26 patients (9.4%). Sinus rhythm was present in 63% of patients at the latest follow-up. Predictive factors for atrial fibrillation recurrence were arrhythmia duration (hazard ratio [HR]=1.296, P=0.045) and atrial fibrillation at hospital discharge (HR=2.03, P=0.019). The monopolar device favored maze success (HR=0.191, P

Original languageEnglish
Pages (from-to)341-347
Number of pages7
JournalTexas Heart Institute Journal
Volume42
Issue number4
DOIs
Publication statusPublished - Aug 3 2015

Keywords

  • Atrial fibrillation/ surgery/therapy
  • Echocardiography
  • Radiofrequency maze
  • Risk factors/analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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