Favourable long-term results using the unmodified maze procedure in patients with medication-refractory or nearly refractory atrial fibrillation; experience from 1993/'04

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 150; no. 42; p. 2314
• Main Authors: Geuzebroek, G S C, Ballaux, Ph K E W, Kelder, J C, Brutel de la Rivière, A, Defauw, J J A M T, van, N M
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 21.10.2006
• Subjects: Atrial Fibrillation - surgery; Coronary Artery Bypass; Female; Heart Conduction System - physiopathology; Heart Conduction System - surgery; Heart Rate; Heart Valves; Humans; Male; Middle Aged; Postoperative Complications - epidemiology; Recurrence; Retrospective Studies; Risk Factors; Treatment Outcome
• ISSN: 0028-2162

To assess the short- and long-term results following the unmodified maze procedure in patients with medication-refractory or nearly refractory atrial fibrillation. Retrospective. We retrospectively collected and analysed preoperatively in-hospital and follow-up data from patients with atrial fibrillation with or without structural heart disease who underwent the unmodified maze procedure in the St. Antonius hospital, Nieuwegein, the Netherlands. In the 11-year period 1993-2004, 203 patients underwent the procedure: 139 underwent the maze procedure only and 64 underwent combined surgery for concomitant atrial fibrillation and structural heart disease. There were no in-hospital deaths. During a mean follow-up period of 4 years, 2 ofthe 203 patients died from cardiac causes; both had undergone combined surgery. With a mean follow-up period of 4 years, the rate of atrial fibrillation-free survival was 90% in patients with lone atrial fibrillation and 70% in patients with concomitant atrial fibrillation. For patients who had no recurrent atrial fibrillation 1 year after surgery, the risk of recurrence after 4 years was small (odds ratio: 9.56). Risk factors for recurrence included a large left atrium and a long duration of atrial fibrillation (more than 5 years). The maze procedure was a successful surgical intervention for patients with atrial fibrillation, both in the short and long term. This procedure can be considered when medication and electrical cardioversion are ineffective.