HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Anton E. Tuinenburg Piet W. Boonstra Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hemels, M. E.W. Articles by Van Gelder, I. C. Search for Related Content PubMed PubMed Citation Articles by Hemels, M. E.W. Articles by Van Gelder, I. C. Related Collections Electrophysiology - arrhythmias

Ann Thorac Surg 2006;81:1773-1779
© 2006 The Society of Thoracic Surgeons

---

Original article: Cardiovascular

Favorable Long-Term Outcome of Maze Surgery in Patients With Lone Atrial Fibrillation

^a Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
^b Department of Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

Accepted for publication October 10, 2005.

^_* Address correspondence to Dr Van Gelder, Department of Cardiology, Thoraxcenter, University Medical Center Groningen, PO Box 30.001, Groningen 9700 RB, the Netherlands (Email: i.c.van.gelder{at}thorax.umcg.nl).

BACKGROUND: Rhythm control is indicated for patients suffering from symptomatic atrial fibrillation (AF), but remains difficult to establish. We investigated the long-term outcome of Cox maze III surgery in patients with symptomatic lone AF refractory to antiarrhythmic drug therapy.

METHODS: Patients with a history of symptomatic paroxysmal or persistent AF refractory for at least two class I or III antiarrhythmic drugs and without structural heart disease or bradyarrhythmias were included. All patients underwent Cox maze III surgery. Complete success was defined as the absence of AF without antiarrhythmic drugs beyond 3 months after the procedure, and partial success as the absence of AF with antiarrhythmic drug use.

RESULTS: A total of 29 patients were included (27 male), with a mean age of 48 ± 6 years. At the time of surgery, 11 patients (38%) had persistent AF. After a mean follow-up of 4.8 ± 2.4 years, 79% of patients had complete success, and 2 patients (7%) were free of AF with antiarrhythmic drugs. At the end of follow-up, left ventricular fractional shortening was significantly improved (from 31% ± 10% to 39% ± 8%, p = 0.002), left atrial size was unchanged, exercise capacity was within normal ranges, and quality of life was comparable with that of healthy controls. Severe complications included reoperations for postoperative bleeding (n = 3), pericardial effusion (n = 1), and mediastinitis (n = 1). In 2 patients, a pacemaker was implanted postoperatively because of sinus node dysfunction.

CONCLUSIONS: Cox maze III surgery is a highly effective therapy for drug-refractory lone AF, and therefore remains an alternative to transvenous pulmonary vein ablation.

This article has been cited by other articles:

				J. M. Stulak, J. A. Dearani, T. M. Sundt III, R. C. Daly, and H. V. Schaff Ablation of Atrial Fibrillation: Comparison of Catheter-Based Techniques and the Cox-Maze III Operation Ann. Thorac. Surg., June 1, 2011; 91(6): 1882 - 1889. [Abstract] [Full Text] [PDF]

				K. L. Grady, R. Lee, H. Subacius, S. C. Malaisrie, E. C. McGee Jr, J. Kruse, J. J. Goldberger, and P. M. McCarthy Improvements in Health-Related Quality of Life Before and After Isolated Cardiac Operations Ann. Thorac. Surg., March 1, 2011; 91(3): 777 - 783. [Abstract] [Full Text] [PDF]

				D. Kozlowski, S. Budrejko, G. Y H Lip, J. Rysz, D. P Mikhailidis, G. Raczak, and M. Banach Lone atrial fibrillation: what do we know? Heart, April 1, 2010; 96(7): 498 - 503. [Abstract] [Full Text] [PDF]

				T. J. Klinkenberg, S. Ahmed, A. T. Hagen, A. C.P. Wiesfeld, E. S. Tan, F. Zijlstra, and I. C. Van Gelder Feasibility and outcome of epicardial pulmonary vein isolation for lone atrial fibrillation using minimal invasive surgery and high intensity focused ultrasound Europace, December 1, 2009; 11(12): 1624 - 1631. [Abstract] [Full Text] [PDF]

				S. Lonnerholm, P. Blomstrom, L. Nilsson, and C. Blomstrom-Lundqvist A high quality of life is maintained late after Maze III surgery for atrial fibrillation Eur J Cardiothorac Surg, September 1, 2009; 36(3): 558 - 562. [Abstract] [Full Text] [PDF]

				C. Lundberg, A. Albage, C. Carnlof, and G. Kenneback Long-Term Health-Related Quality of Life After Maze Surgery for Atrial Fibrillation Ann. Thorac. Surg., December 1, 2008; 86(6): 1878 - 1882. [Abstract] [Full Text] [PDF]

				A. A. Ghavidel, H. Javadpour, M. Shafiee, M.-B. Tabatabaie, K. Raiesi, and S. Hosseini Cryoablation for surgical treatment of chronic atrial fibrillation combined with mitral valve surgery: a clinical observation Eur J Cardiothorac Surg, June 1, 2008; 33(6): 1043 - 1048. [Abstract] [Full Text] [PDF]

				E. S. Tan, M. Rienstra, A. C.P. Wiesfeld, B. A. Schoonderwoerd, H. H.F. Hobbel, and I. C. Van Gelder Long-term outcome of the atrioventricular node ablation and pacemaker implantation for symptomatic refractory atrial fibrillation Europace, April 1, 2008; 10(4): 412 - 418. [Abstract] [Full Text] [PDF]

				T. Fleck, F. Wolf, T. Bader, R. Lehner, C. Aigner, G. Stix, E. Wolner, and W. Wisser Atrial Function After Ablation Procedure in Patients With Chronic Atrial Fibrillation Using Steady-State Free Precession Magnetic Resonance Imaging Ann. Thorac. Surg., November 1, 2007; 84(5): 1600 - 1604. [Abstract] [Full Text] [PDF]

				E. Sagbas, B. Akpinar, I. Sanisoglu, B. Caynak, B. Tamtekin, K. Oral, and B. Onan Video-Assisted Bilateral Epicardial Pulmonary Vein Isolation for the Treatment of Lone Atrial Fibrillation Ann. Thorac. Surg., May 1, 2007; 83(5): 1724 - 1730. [Abstract] [Full Text] [PDF]