Key result
Concomitant maze IV yields only ~25% drug-free AF freedom at 7 years.
Why the study?
Does concomitant maze IV (CMIV) surgery prevent late AF recurrence in patients with atrial fibrillation?
Cohort (n=144)
No
Does concomitant maze IV (CMIV) surgery prevent late AF recurrence in patients with atrial fibrillation?
Concomitant maze IV surgery demonstrated limited long-term efficacy in maintaining sinus rhythm in an unselected atrial fibrillation population.
Limited long-term maze IV success in unselected AF patients cautions against routine use; hypothesis-generating for refined selection and randomized trials.
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia, and associated with increased risk of morbidity and mortality. AF surgery is widely used for rhythm control of AF, but previous studies have shown varying results. This study sought to investigate the long-term efficacy of concomitant maze IV (CMIV) surgery in an unselected AF population and identify predictors of late AF recurrence. METHODS: In total 144 consecutive patients, who underwent CMIV between January 2006 and December 2010 were enrolled. By data from electronic medical records, registers, and rhythm prints, late AF recurrences and heart rhythm at latest follow-up were retrospectively registered. All patients still alive were invited to an ambulant follow-up to update rhythm status. RESULTS: = 0.011) as predictors. CONCLUSION: CMIV in the present cohort provided limited long-term success in obtaining SR. SAF, longer AF duration, and postoperative ATA were associated with late AF recurrence.
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Engelsgaard et al. (2018) conducted a cohort in Atrial fibrillation (n=144). Concomitant maze IV (CMIV) surgery was evaluated on Freedom from late atrial fibrillation recurrence without antiarrhythmic drugs at 7 years. Concomitant maze IV surgery demonstrated limited long-term efficacy, with only 25.1% of patients remaining free from atrial fibrillation without antiarrhythmic drugs at 7 years, and sustained AF strongly predicted recurrence.
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