Preoperative left atrial volume index is a predictor of successful sinus rhythm restoration and maintenance after the maze operation.
OBJECTIVE
The purpose of this study was to identify the relationship of preoperative and postoperative left atrial volume indices and dimensions with successful restoration of sinus rhythm after the maze operation.


METHODS
Forty-three patients who underwent the Cox-maze III procedure for permanent atrial fibrillation in conjunction with surgical intervention for various heart diseases were evaluated. Echocardiographic studies were performed preoperatively and 3 months postoperatively. Volumes and dimensions were corrected for body surface area and analyzed.


RESULTS
Sinus rhythm was restored and maintained in 36 (83.7%) of the 43 patients. The preoperative left atrial volume index of the group with successful restoration of sinus rhythm (group A) was significantly smaller than that of the group with unsuccessful restoration (group B: 76.7 +/- 16.4 vs 108.9 +/- 43.9 mL/m2, P = .047). In group A the volume index (76.7 +/- 16.4 vs 52.3 +/- 15.0 mL/m2, P < .001) and dimension index (35.8 +/- 6.2 vs 30.8 +/- 4.7 mL/m2, P < .001) decreased significantly 3 months after the operation. No such significant changes were found in group B. The duration of arrhythmia for group A was significantly shorter than that for group B (3.4 +/- 2.8 vs 13.7 +/- 8 years, P = .001).


CONCLUSIONS
The preoperative left atrial volume index, as opposed to the conventional left atrial dimension, and the duration of arrhythmia are important predictors of successful sinus rhythm restoration after the maze operation. A significant reduction of the volume index can be achieved in patients whose rhythm is successfully restored and maintained after the procedure.
Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea.
Yong Hoon
YH
Kim
Sang-Chol
SC
Lee
Ae Young
AY
Her
Hak Jin
HJ
Kim
Jin Oh
JO
Choi
Dae Hee
DH
Shin
Sung Won
SW
Cho
Wang Soo
WS
Lee
Seung Woo
SW
Park
Pyo Won
PW
Park
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D016009:Chi-Square Distribution; D003452:Cryosurgery / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome