Korean J Thorac Cardiovasc Surg.  2014 Aug;47(4):358-366.

Outcome of Concomitant Cox Maze Procedure with Narrow Mazes and Left Atrial Volume Reduction

• Choi JB
• Kim JH
• Cha BK

Abstract

BACKGROUND
To improve sinus rhythm conversion, the Cox maze III procedure with narrow mazes (width: < or =3.0 cm) was performed in combination with left atrial volume reduction.
METHODS
From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients.
RESULTS
At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001).
CONCLUSION
For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.

Keyword

Arrhythmia surgery; Technique; Outcome assessment

MeSH Terms

Atrial Fibrillation
Echocardiography
Electrocardiography
Electrocardiography, Ambulatory
Follow-Up Studies
Humans
Mitral Valve