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Original Articles: Adult Cardiac

Long-Term Health-Related Quality of Life After Maze Surgery for Atrial Fibrillation

^a Department of Cardiology, Karolinska Institute at Södersjukhuset, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
^b Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
^c Department of Cardiology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden

Accepted for publication July 22, 2008.

^_* Address correspondence to Dr Lundberg, Department of Cardiology, Södersjukhuset, Stockholm, SE-118 83, Sweden (Email: lundbergcatharina{at}gmail.com).

Background: Atrial fibrillation (AF) significantly impairs health-related quality of life (QoL). As pharmacologic treatment may have intolerable side effects and is not always effective, other techniques for curing AF have evolved. The maze III procedure has a high long-term success rate in restoring and maintaining sinus rhythm, but the long-term impact on QoL has not been sufficiently demonstrated.

Methods: Thirty-four patients underwent the maze III procedure for paroxysmal (n = 9), persistent (n = 15) or permanent (n = 10) AF. Quality of life was assessed with the Swedish Short Form-36 survey. Mean follow-up time was 35 ± 6 months.

Results: Sinus rhythm was maintained in 32 patients (94%). For all domains except bodily pain, all patients reported substantial worse QoL at baseline as compared with healthy controls. Postoperatively all scores improved significantly to the level of the general population, and for the majority of the scoring items this was observed after 12 months. Improvement was maintained during the remaining observation period.

Conclusions: The maze III procedure significantly improves QoL in patients with AF. The results are consistent during an observation time of 35 months. Based on QoL effects in a long-term perspective, maze surgery should be considered in symptomatic patients with AF refractory to pharmacologic treatment or catheter ablation.

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