title: A modified Cox maze IV procedure: a simpler technique for the surgical treatment of atrial fibrillation.
abstract: To determine the effectiveness of a simplified surgical treatment method for atrial fibrillation (AF).
  
  
  
  Between September 2012 and October 2013, 120 patients (mean age, 52.3 ± 8.8 years) underwent valve surgery and concomitant bipolar radiofrequency ablation for the treatment of AF. Patients were randomized to a Cox maze IV procedure (CMP-IV) group (n = 60) or a modified CMP-IV (MCMP-IV) group (n = 60). Freedom from AF was defined as freedom from any left atrial arrhythmia lasting <30 s and no requirement of antiarrhythmic drugs after 6 months. Data were recorded at postoperative follow-up examinations, which were scheduled at 1, 3, 6 and 12 months, and annually thereafter.
  
  
  
  No ablation-related complications occurred in either group. The mean ablation time was longer in the CMP-IV group than in the MCMP-IV group (18.5 ± 1.7 vs 16.6 ± 1.6 min, P < 0.001). The mean follow-up time was 32.4 ± 3.6 months (range, 26-39 months). Freedom from AF tended to be higher, but not significantly so, among the MCMP-IV group than among the CMP-IV group over the entire follow-up period.
  
  
  
  The MCMP-IV is an effective surgical procedure for the treatment of AF. In certain patients, such as those with anatomic variations of the pulmonary veins, the MCMP-IV is simpler than the CMP-IV.
  
  
  
  ChiCTR-TRC-12002742.
authors: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Jun
authors: J
authors: Shi
authors: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Zhi-Xuan
authors: ZX
authors: Bai
authors: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Ben-Gui
authors: BG
authors: Zhang
authors: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors: Wen-Jun
authors: WJ
authors: Ren
authors: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China drguoyq@yahoo.com.
authors: Ying-Qiang
authors: YQ
authors: Guo
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Atrial fibrillation; Cox maze IV procedure; Radiofrequency ablation; Randomized clinical trial