Key result
The Cox maze procedure with narrow mazes and left atrial volume reduction resulted in a 94.2% sinus rhythm conversion rate at a mean follow-up of 36.4 months without the preventive use of anti-arrhythmic drugs.
Why the study?
Does the Cox maze procedure with narrow mazes and left atrial volume reduction improve sinus rhythm conversion in patients with atrial fibrillation undergoing concomitant cardiac surgery?
Cohort (n=87)
No
Does the Cox maze procedure with narrow mazes and left atrial volume reduction improve sinus rhythm conversion in patients with atrial fibrillation undergoing concomitant cardiac surgery?
The Cox maze procedure using narrow mazes (≤3.0 cm) and left atrial volume reduction achieves a high rate of sinus rhythm conversion (94.2%) without the need for preventive anti-arrhythmic drugs.
May support narrow-maze Cox III plus LA reduction for AF conversion; leaves open need for randomized trials.
BACKGROUND: TO IMPROVE SINUS RHYTHM CONVERSION, THE COX MAZE III PROCEDURE WITH NARROW MAZES (WIDTH: ≤3.0 cm) was performed in combination with left atrial volume reduction. METHODS: From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients. RESULTS: At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001). CONCLUSION: For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.
No takes yet. Share an insight, caveat, or question.
Choi et al. (2014) conducted a cohort in Atrial fibrillation (n=87). Cox maze procedure with narrow mazes and left atrial volume reduction was evaluated on Sinus rhythm conversion at last follow-up. The Cox maze procedure with narrow mazes and left atrial volume reduction resulted in a 94.2% sinus rhythm conversion rate at a mean follow-up of 36.4 months without the preventive use of anti-arrhythmic drugs.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: