Mid-term Result of Operations for Atrial Fibrillation

Choi, Jong Bum; Koh, Kwang Pyo; Han, Jae O

Abstract

BACKGROUND
Majority of patients with mitral valve disease and chronic atrial fibrillation can resume sinus rhythm with the maze procedure. The purpose of this study is to identify mid-term outcome and possibility of recurrent atrial fibrillation in the patients who underwent mitral valve operation and the maze procedure. MATERIAL AND METHOD: A retrospective study was undertaken on 11 consecutive patients(including 10 patients with rheumatic mitral valve disease) operated on for mitral valve disease and chronic atrial fibrillation. Maze II and its modified procedure were performed in 6 patients and maze III and its modified procedures in 5 patients. Postoperative left atrial contractility was compared between the patients that underwent mitral valve operation and maze procedure and the patients with mitral valve procedure and medication of anti-arrhythmic drugs. RESULT: Five(83.3%) of 6 patients with maze II procedure and all 5 patients(100%) with maze III procedure resumed sinus rhythm. In 1(20%) of 5 patients with sinus rhythm after maze II procedure and 2(40%) of 5 patients with sinus rhythm after maze III procedure, atrial fibrillation recurred 23, 2, and 13 months after the operations, respectively. None of three patients with the modified procedure had recurrence of atrial fibrillation. Of 3 patients with recurrent atrial fibrillation, 2 patients resumed sinus rhythm and 1 still had atrial fibrillation. After the maze procedures, only 4 (40%) of 10 patients with sinus rhythm presented left atrial contraction, and their mean velocity of mitral 'A' wave was lower than that of the patients who resumed sinus rhythm with only valve replacement and anti-arrhythmic drugs.
CONCLUSION
Although the maj ority of patients with mitral valve disease and chronic atrial fibrillation can resume sinus rhythm with the maze procedure associated with mitral valve operation, atrial fibrillation may recur in mid-term. Also, the left atrial contractility may be very poor in patients who resumed sinus rhythm with maze procedure.