title: Outcome of concomitant cox maze procedure with narrow mazes and left atrial volume reduction.
abstract: BACKGROUND
  TO IMPROVE SINUS RHYTHM CONVERSION, THE COX MAZE III PROCEDURE WITH NARROW MAZES (WIDTH: ≤3.0 cm) was performed in combination with left atrial volume reduction.
  
  
  METHODS
  From October 2007 to April 2013, 87 patients with atrial fibrillation (paroxysmal in 3, persistent in 14, and permanent in 70) underwent the Cox maze procedure concomitant with another cardiac procedure. They were followed-up with serial electrocardiographic and echocardiographic studies. We used 24-hour Holter monitoring tests to evaluate postoperatively symptomatic patients.
  
  
  RESULTS
  At the mean follow-up time of 36.4 months, 81 patients (94.2%) had sinus rhythm and two were on anti-arrhythmic medication (one on a beta-blocker and the other on amiodarone). Five patients (5.8%) with postoperative recurrent and persistent atrial fibrillation never experienced sinus rhythm conversion; however, they did not require any medication for rate control. On postoperative echocardiography, the left atrial A waves were more frequently observed after concomitant mitral valve repair than after concomitant mitral valve replacement (82.4% vs. 40.4%, respectively; p<0.001).
  
  
  CONCLUSIONS
  For the Cox maze procedure, narrow mazes and atrial volume reduction resulted in excellent sinus rhythm conversion without the preventive use of anti-arrhythmic drugs, and they did not affect the presence of the left atrial A waves on echocardiography.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School ; Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institute of Chonbuk National University Hospital.
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School ; Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institute of Chonbuk National University Hospital.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School ; Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institute of Chonbuk National University Hospital.
authors.forename: Byong Ki
authors.initials: BK
authors.lastname: Cha
keywords: Arrhythmia surgery; Outcome assessment; Technique