Atrial tachyarrhythmias after the maze procedure: incidence and prognosis.
BACKGROUND
The Maze procedure restores normal sinus rhythm in the majority of patients. However, atrial tachyarrhythmias (ATA) are a common early complication after the operation. The purpose of this study was to define the incidence and natural history of ATA after the Maze procedure.


METHODS
Complete medical records from 200 patients who underwent the Maze procedures (I, II, and III) from 1987 to 2002 were examined for all episodes of early postoperative ATA that occurred during the first 30 days after the procedure. Two electrophysiologists independently reviewed all postoperative 12-lead electrocardiograms.


RESULTS
ATA occurred in 86 patients (43%) after the Maze procedure. Of the patients with ATA, 59% had atrial fibrillation (AF), 14% had atrial flutter (AFL), and 27% had both AF and AFL. Of the patients with AF or AFL, 20% and 5%, respectively, also had episodes of atrial tachycardia and supraventricular tachyarrhythmia. The peak incidence of early postoperative ATA was on postoperative day 8. The average duration of ATA was 5.7+/-5.0 days. Late recurrence of AF (>1 year postoperatively) occurred in 7.0% of patients who had early postoperative ATA and 8.8% of patients without early postoperative ATA (P=0.8).


CONCLUSIONS
ATA occurred in 43% of patients after the Maze procedure. The tachyarrhythmias occurred primarily within 8 days after surgery and resolved within 3 weeks in almost all patients. There was no relationship between the incidence of early postoperative ATA and the late recurrence of AF.
Ishii
Yosuke
Y
Washington University School of Medicine, Division of Cardiothoracic Surgery, St. Louis, Mo, USA.
Gleva
Marye J
MJ
Gamache
M Carolyn
MC
Schuessler
Richard B
RB
Boineau
John P
JP
Bailey
Marci S
MS
Damiano
Ralph J
RJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D001282:Atrial Flutter / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D015897:Comorbidity; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery*; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012494:Sampling Studies; D013610:Tachycardia / Q000453:epidemiology*; D013617:Tachycardia, Supraventricular / Q000453:epidemiology; D016896:Treatment Outcome