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Ann Thorac Surg 2002;74:S1301-S1306
© 2002 The Society of Thoracic Surgeons
lhan Saniso
lu, MDaba
, MDa
a Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul, Turkey
b Department of Anesthesia, Kadir Has University, Florence Nightingale Hospital, Istanbul, Turkey
* Address reprint requests to Dr Akpinar, Florence Nightingale Hospital, Abide’i HÜrriyet Cad. No:290, 80220 
L, Istanbul, Turkey
e-mail: belh{at}turk.net
Presented at the Eighth Annual Cardiothoracic Techniques and Technologies Meeting 2002, Miami Beach, FL, Jan 23–26, 2002.
BACKGROUND: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified Maze operation for treatment of chronic atrial fibrillation, and to compare the results of the left and biatrial procedures.
METHODS: During a period of 11 months, 62 patients with chronic atrial fibrillation who were having concomitant cardiac surgery underwent the procedure. The mean age of the patients was 52 ± 14 years. Patients underwent either a biatrial (group A; n = 39) or left atrial (group B; n = 23) procedure.
RESULTS: Two patients (3.2%) died early in the postoperative period. Three patients (4.8%) required reoperation for bleeding. One patient in group A (1.6%) received a permanent pacemaker. Patients in both groups were free of atrial fibrillation at the end of the procedure (group A: sinus 86.9%, pacemaker 13%; group B: sinus 90.5%, pacemaker 9.5%) (p > 0.05). At 1-month and longer-term follow-up, sinus rhythm was maintained in 92% and 95% of cases in group A, respectively, whereas this rate was 71% and 81% in group B (p > 0.05). Holter monitor surveillance revealed a higher rate of atrial fibrillation, atrial arrhythmias, and atrial flutter in group B (p < 0.05). Transthoracic echocardiography revealed improvement over time in left atrial transport function in both groups (p < 0.05).
CONCLUSIONS: The saline-irrigated radiofrequency modified Maze procedure was performed safely and efficiently. Both the left and biatrial procedures were successful in terms of restoring sinus rhythm during short-term follow-up. Long-term follow-up with more cases is needed to show the superiority of one method over the other.
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