Left versus bi-atrial intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation.
BACKGROUND
This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures.


METHODS
During a period of two years, 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure. Patients underwent either a bi-atrial ( n = 48) or left atrial ( n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 +/- 11 years in bi-atrial group and 54 +/- 9 years in left atrial group.


RESULTS
Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2%, pacemaker: 20.8%), (Left atrial group: sinus: 82.5%, pacemaker: 17.5%) ( p > 0.05). During the last follow-up, sinus rhythm was maintained in 79.6% of cases in bi-atrial group, while this rate was 75.6% in left atrial group ( p > 0.05).


CONCLUSIONS
Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side.
Guden
Mustafa
M
Department of Cardiovascular Surgery, Kadir Has University, Florence Nightingale Hospital, Istanbul-Turkey.
Akpinar
Belhhan
B
Caynak
Baris
B
Turkoglu
Cavlan
C
Ozyedek
Zeki
Z
Sanisoglu
Ilhan
I
Sagbas
Ertan
E
Aytekin
Saide
S
Oztekin
Seher Deniz
SD
D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D002908:Chronic Disease; D015716:Electrocardiography, Ambulatory; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012965:Sodium Chloride; D013536:Suture Techniques
D012965:Sodium Chloride