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Wu CC, Chang JP, Chen MC, et al. Long-term results of radiofrequency maze procedure for persistent atrial fibrillation with concomitant mitral surgery. J Thorac Dis. 2017;9(12):5176-5183doi: 10.21037/jtd.2017.11.112.
Wu, C. C., Chang, J. P., Chen, M. C., Cheng, C. I., & Chung, W. J. (2017). Long-term results of radiofrequency maze procedure for persistent atrial fibrillation with concomitant mitral surgery. Journal of thoracic disease, 9(12), 5176-5183. https://doi.org/10.21037/jtd.2017.11.112
Wu, Chia-Chen, et al. "Long-term results of radiofrequency maze procedure for persistent atrial fibrillation with concomitant mitral surgery." Journal of thoracic disease vol. 9,12 (2017): 5176-5183. doi: https://doi.org/10.21037/jtd.2017.11.112
Wu CC, Chang JP, Chen MC, Cheng CI, Chung WJ. Long-term results of radiofrequency maze procedure for persistent atrial fibrillation with concomitant mitral surgery. J Thorac Dis. 2017 Dec;9(12):5176-5183. doi: 10.21037/jtd.2017.11.112. PMID: 29312724; PMCID: PMC5756962.
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J Thorac Dis. 2017 Dec;9(12):5176-5183. doi: 10.21037/jtd.2017.11.112.

Long-term results of radiofrequency maze procedure for persistent atrial fibrillation with concomitant mitral surgery.

Journal of thoracic disease

Chia-Chen Wu, Jen-Ping Chang, Mien-Cheng Chen, Cheng-I Cheng, Wen-Jung Chung

Affiliations

  1. Division of Thoracic and Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City, Taiwan.
  2. Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung City, Taiwan.

PMID: 29312724 PMCID: PMC5756962 DOI: 10.21037/jtd.2017.11.112

Abstract

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 cm

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.

Keywords: Atrial fibrillation (AF); maze procedure; mitral surgery; radiofrequency (RF)

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

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