Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Predictive Factors of Sustained Sinus Rhythm and Recurrent Atrial Fibrillation after the Maze Procedure

  • Choi, Jong Bum (Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Park, Hyun Kyu (Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Kim, Kyung Hwa (Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Kim, Min Ho (Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Kuh, Ja Hong (Department of Thoracic and Cardiovascular Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School) ;
  • Lee, Mi-Kyung (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine) ;
  • Lee, Sam Youn (Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine)
  • Received : 2012.07.30
  • Accepted : 2012.10.17
  • Published : 2013.04.05
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Abstract

Background: We examined perioperative predictors of sustained sinus rhythm (SR) in patients undergoing the Cox maze operation and concomitant cardiac surgery for structural heart disease. Materials and Methods: From October 1999 to December 2008, 90 patients with atrial fibrillation (AF) underwent the Cox maze operation and other concomitant cardiac surgery. Eighty-nine patients, all except for one postoperative death, were followed-up with serial electrocardiographic studies, 24-hour Holter monitoring tests, and regular echocardiographic studies. Results: Eighty-nine patients undergoing the maze operation were divided into two groups according to the presence of SR. At the time of last follow-up (mean follow-up period, $51.0{\pm}30.8$ months), 79 patients (88.8%) showed SR (SR group) and 10 patients (11.2%) had recurrent AF (AF group). Factors predictive of sustained SR were the immediate postoperative conversion to SR (odds ratio, 97.2; p=0.001) and the presence of SR at the 6th month postoperatively (odds ratio, 155.7; p=0.002). Duration of AF, mitral valve surgery, number of valves undergoing surgery, left atrial dimension, and perioperative left ventricular dimensions and ejection fractions were not predictors of postoperative maintenance of SR. Conclusion: Immediate postoperative SR conversion and the presence of SR at the 6th postoperative month were independent predictors of sustained SR after the maze operation.

Keywords

References

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  2. Late Results of Cox Maze III Procedure in Patients with Atrial Fibrillation Associated with Structural Heart Disease vol.109, pp.1, 2013, https://doi.org/10.5935/abc.20170082