Key result
The absence of atrial contraction after a maze procedure combined with valve surgery increased the risk of permanent pacemaker implantation.
Why the study?
Does the absence of atrial contraction increase the risk of permanent pacemaker implantation in patients undergoing the maze procedure combined with valve surgery?
Cohort (n=376)
No
Does the absence of atrial contraction increase the risk of permanent pacemaker implantation in patients undergoing the maze procedure combined with valve surgery?
The absence of atrial contraction recovery after a maze procedure combined with valve surgery is a strong predictor of the need for subsequent permanent pacemaker implantation.
Answers are grounded in this paper and cite their sources.
May warrant closer post-maze surveillance for pacemaker need; leaves open causal links and intervention effects in prospective studies.
BACKGROUND: The absence of atrial contraction (AC) after the maze procedure has been reported to cause subsequent annular dilatation and to increase the risk of embolic stroke. We hypothesized that the lack of AC could increase the risk of permanent pacemaker (PPM) implantation in patients undergoing the maze procedure. METHODS: In 376 consecutive patients who had undergone a cryo-maze procedure and combined valve operation, recovery of AC was assessed at baseline and at immediate (≤2 weeks), early (≤1 year, 4.6±3.8 months), and late (>1 year, 3.5±1.1 years) postoperative stages. RESULTS: With a median follow-up of 53 months, 10 patients underwent PPM implantation. Seven PPM implants were for sinus node dysfunction (pauses of 9.6±2.4 seconds), one was for marked sinus bradycardia, and two were for advanced/complete atrioventricular block. The median (interquartile range) time to PPM implantation was 13.8 (0.5-68.2) months. Our time-varying covariate Cox models showed that the absence of AC was a risk factor for PPM implantation (hazard ratio, 11.92; 95% confidence interval, 2.52 to 56.45; p=0.002). CONCLUSION: The absence of AC may be associated with a subsequent risk of PPM implantation.
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Jeon et al. (2017) conducted a cohort in Atrial fibrillation and valvular heart disease (n=376). Absence of atrial contraction vs. Recovery of atrial contraction was evaluated on Permanent pacemaker implantation (HR 11.92, 95% CI 2.52 to 56.45, p=0.002). The absence of atrial contraction after a maze procedure combined with valve surgery increased the risk of permanent pacemaker implantation.
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