title: Antiarrhythmic surgery to cure atrial fibrillation--subgroups and postoperative management.
abstract: Antiarrhythmic surgical procedures to cure atrial fibrillation (AF) are widely used in cardiac surgery. Whereas the Cox maze procedure remains the highly effective gold-standard a variety of different antiarrhythmic procedures aim at reducing the extent and duration of the procedure. Antiarrhythmic procedures are especially effective in patients undergoing mitral valve surgery. In 110 patients with permanent AF undergoing various surgical procedures sinus rhythm was re-established in 75%. Subgroup analyses revealed no significant differences in rhythm or survival after antiarrhythmic intraoperative ablation indicating the usefulness and feasibility of this procedure in patients with a wide range of characteristics. Because conversion usually occurs spontaneously within the first 6 months and antiarrhythmic medication does not increase the incidence of conversion it seems reasonable to wait for spontaneous occurrence of sinus rhythm after antiarrhythmic intraoperative ablation. In patients with permanent AF undergoing open heart surgery additional antiarrhythmic procedures have been shown to be safe and effective.
authors.affiliation: Clinic II (Cardiology), Bergmannsheil Bochum, Germany. thomas.deneke@ruhr-uni-bochum.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
authors.forename: Krishna
authors.initials: K
authors.lastname: Khargi
authors.forename: Peter H
authors.initials: PH
authors.lastname: Grewe
authors.forename: Frank
authors.initials: F
authors.lastname: Kuschkowitz
authors.forename: Axel
authors.initials: A
authors.lastname: Laczkovics
authors.forename: Bernd
authors.initials: B
authors.lastname: Lemke
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004554:Electric Countershock; D006325:Heart Atria / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans
chemical_list: D000889:Anti-Arrhythmia Agents