Radiofrequency maze procedure with concomitant mitral surgery achieved long-term sinus conversion in 74.4% of patients after a mean follow-up of 101 months.
Cohort (n=207)
Does the radiofrequency maze procedure restore long-term sinus rhythm in patients with persistent atrial fibrillation undergoing concomitant mitral surgery?
The RF maze procedure during mitral surgery provides long-term sinus rhythm in approximately 74% of patients, with success rates decreasing in those with longer AF duration and larger atrial dimensions.
Background: The radiofrequency (RF) maze procedure can effectively restore sinus rhythm in most patients with persistent atrial fibrillation (AF) and mitral disease. However, long-term results and predictors for late AF recurrence are still under investigation. Methods: From December 1995 to November 2011, 207 consecutive patients with persistent AF and mitral disease underwent RF maze procedure and concomitant mitral surgery. The mean age was 54±12.4 year-old. Mitral surgery was performed in all patients and concomitant procedures including tricuspid surgery, aortic valve surgery, and atrial septal defect closure were carried on 164 patients. Results: The in-hospital mortality was 3.9% (n=8) and late mortality was 8.2% (n=17). After a mean follow-up period of 101±50.9 months, 154 patients (74.4%) had long-term sinus conversion. A permanent pacer was implanted in 8 patients (3.9%). By Cox multivariate survival regression analysis, predictors for long-term sinus conversion were identified to be the duration of persistent AF, preoperative left atrial (LA) diameter, preoperative right atrial (RA) area, and preoperative beta-blocker use. The receiver operating characteristic (ROC) curve analysis showed that the best cutoff value for persistent AF duration, preoperative LA diameter, and preoperative RA area were 59.5 months, 59.85 mm, and 25.65 cm2. Conclusions: Longer persistent AF duration, larger preoperative LA diameter, larger preoperative RA area and preoperative beta-blocker use were the predictors for negative long-term outcome of RF maze procedure for the patients with persistent AF underwent concomitant mitral surgery. Timely referral of patients for surgery is mandatory.
Wu et al. (Fri,) conducted a cohort in persistent atrial fibrillation and mitral disease (n=207). Radiofrequency (RF) maze procedure and concomitant mitral surgery was evaluated on long-term sinus conversion. Radiofrequency maze procedure with concomitant mitral surgery achieved long-term sinus conversion in 74.4% of patients after a mean follow-up of 101 months.