Results of maze surgery for lone paroxysmal atrial fibrillation.

Abstract:

BACKGROUND:If drug refractoriness to paroxysmal atrial fibrillation (PAF) occurs, arrhythmia surgery that involves channelling and the exclusion of specific atrial areas can abolish atrial fibrillation. The purpose of this study was to establish the effectiveness and safety of maze III surgery to abolish PAF. METHODS AND RESULTS:Surgery was performed in 41 selected patients who had long-standing, symptomatic, drug-refractory, lone PAF. At discharge, 35 patients (85%) were arrhythmia free, and 6 patients (15%) showed PAF and paroxysmal atrial tachycardia. Death or stroke did not occur during a mean follow-up of 31+/-16 months. At the end of follow-up, 39 patients (95%) had no PAF; however, in 2 patients (5%), PAF persisted and eventually required His bundle ablation and pacing. Three months after surgery, nodal escape rhythm was observed in only 1 patient, whereas sick-sinus syndrome emerged late after surgery in 2 patients. Antiarrhythmic drugs were used in 20% of patients during follow-up. The quality of life improved markedly after surgery and remained unchanged afterward. Echocardiographic findings did not alter, but exercise capacity increased. CONCLUSIONS:This pilot study demonstrates the effectiveness and safety of maze III surgery for lone PAF. In patients without sick-sinus syndrome, this intervention offers a sensible alternative to His bundle ablation and lifelong pacemaker dependency.

journal_name

Circulation

journal_title

Circulation

authors

Jessurun ER,van Hemel NM,Defauw JA,Stofmeel MA,Kelder JC,de la Rivière AB,Ernst JM

doi

10.1161/01.cir.101.13.1559

subject

Has Abstract

pub_date

2000-04-04 00:00:00

pages

1559-67

issue

13

eissn

0009-7322

issn

1524-4539

journal_volume

101

pub_type

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