Korean J Thorac Cardiovasc Surg.  2013 Apr;46(2):117-123. 10.5090/kjtcs.2013.46.2.117.

Predictive Factors of Sustained Sinus Rhythm and Recurrent Atrial Fibrillation after the Maze Procedure

• Choi JB
• Park HK
• Kim KH
• Kim MH
• Kuh JH
• Lee MK
• Lee SY

• KMID: 1427805
• DOI: http://doi.org/10.5090/kjtcs.2013.46.2.117

Abstract

BACKGROUND
We examined perioperative predictors of sustained sinus rhythm (SR) in patients undergoing the Cox maze operation and concomitant cardiac surgery for structural heart disease.
MATERIALS AND METHODS
From October 1999 to December 2008, 90 patients with atrial fibrillation (AF) underwent the Cox maze operation and other concomitant cardiac surgery. Eighty-nine patients, all except for one postoperative death, were followed-up with serial electrocardiographic studies, 24-hour Holter monitoring tests, and regular echocardiographic studies.
RESULTS
Eighty-nine patients undergoing the maze operation were divided into two groups according to the presence of SR. At the time of last follow-up (mean follow-up period, 51.0+/-30.8 months), 79 patients (88.8%) showed SR (SR group) and 10 patients (11.2%) had recurrent AF (AF group). Factors predictive of sustained SR were the immediate postoperative conversion to SR (odds ratio, 97.2; p=0.001) and the presence of SR at the 6th month postoperatively (odds ratio, 155.7; p=0.002). Duration of AF, mitral valve surgery, number of valves undergoing surgery, left atrial dimension, and perioperative left ventricular dimensions and ejection fractions were not predictors of postoperative maintenance of SR.
CONCLUSION
Immediate postoperative SR conversion and the presence of SR at the 6th postoperative month were independent predictors of sustained SR after the maze operation.

Keyword

Arrhythmia surgery; Recurrence; Outcome assessment

MeSH Terms

Atrial Fibrillation
Cellulose
Electrocardiography
Electrocardiography, Ambulatory
Follow-Up Studies
Heart
Humans
Mitral Valve
Recurrence
Thoracic Surgery
Cellulose