Intraoperative Saline-Irrigated Radiofrequency Modified Maze Procedure for Atrial Fibrillation

Abstract

Background. This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified Maze operation for treatment of chronic atrial fibrillation and to compare the results of the left and biatrial procedures. Methods. During a period of 11 months 62 patients with chronic atrial fibrillation who were having concomitant cardiac surgery underwent the procedure. The mean age of the patients was 52 +/- 14 years. Patients underwent either a biatrial (group A

n = 39) or left atrial (group B

n = 23) procedure. Results. Two patients (3.2%) died early in the postoperative period. Three patients (4.8%) required reoperation for bleeding. One patient in group A (1.6%) received a permanent pacemaker. Patients in both groups were free of atrial fibrillation at the end of the procedure (group A: sinus 86.9% pacemaker 13%

group B: sinus 90.5% pacemaker 9.5%) (p > 0.05). At 1-month and longer-term follow-up sinus rhythm was maintained in 92% and 95% of cases in group A respectively whereas this rate was 71% and 81% in group B (p > 0.05). Holter monitor surveillance revealed a higher rate of atrial fibrillation atrial arrhythmias and atrial flutter in group B (p < 0.05). Transthoracic echocardiography revealed improvement over time in left atrial transport function in both groups (p < 0.05). Conclusions. The saline-irrigated radiofrequency modified Maze procedure was performed safely and efficiently. Both the left and biatrial procedures were successful in terms of restoring sinus rhythm during short-term follow-up. Long-term follow-up with more cases is needed to show the superiority of one method over the other.