Freedom from atrial arrhythmias after classic maze III surgery: A 10-year experience

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 132; no. 6; pp. 1433 - 1440
• Main Authors: Ballaux, Philippe K.E.W., Geuzebroek, Guillaume S.C., van Hemel, Norbert M., Kelder, Johannes C., Dossche, Karl M.E., Ernst, Jef M.P.G., Boersma, Lukas V.A., Wever, Eric F.D., de la Rivière, Aart Brutel, Defauw, Jo J.A.M.T.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.12.2006; AATS/WTSA; Elsevier
• Subjects: Arrhythmias, Cardiac - surgery; Biological and medical sciences; Cardiac dysrhythmias; Cardiac Surgical Procedures - methods; Cardiology. Vascular system; Female; Follow-Up Studies; Heart; Heart Atria; Humans; Male; Medical sciences; Middle Aged; Remission Induction; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Time Factors; 24; OR; PAF; AF; AV; LA; AFL; CAF; CL; CVA; RA; Heart; Experience; Treatment; Arrhythmia; Heart disease; Surgery; Maze procedure; Cardiovascular disease; Thorax
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2006.06.048

We studied the persistence of favorable outcome, the occurrence of new atrial arrhythmias, and sinus node dysfunction in patients who underwent the maze III procedure. Preoperative, in-hospital, and follow-up data of 203 patients who underwent the maze III procedure between June 1993 and June 2003 were collected. A total of 139 patients underwent the maze procedure for lone atrial fibrillation, and 64 patients underwent the maze procedure and concomitant cardiac surgery. There was no 30-day postoperative mortality. During a mean follow-up of 4.0 ± 2.6 years, 12 patients (6%) died (2 cardiac related). At the end of follow-up, freedom from supraventricular arrhythmias was 80% for the lone atrial fibrillation group and 64% for the concomitant atrial fibrillation group. Freedom from stroke during follow-up was 100% in the lone atrial fibrillation group and 97% in the concomitant group. Multivariate analysis revealed that rhythm at 1-year follow-up ( P < .001; odds ratio 9.56, 95% confidence limits 3.92-23.31) and preoperative left atrium dimension ( P = .028; odds ratio 1.06 for every millimeter, 95% confidence limits 1.01-1.12) were predictors of success at the end of follow-up. This study shows that the favorable results of the maze III procedure in terms of freedom from supraventricular arrhythmias persist in most patients for at least 4 years.