Surgery for atrial fibrillation

There are two major surgical methods for atrial fibrillation (AF) treatment : maze and corridoring procedures. The first one prevents AF occurrence by interrupting all of the potential macroreentrant circuits that can develop in the atria thus precluding the possibility of atria to fibrillate. Second procedure creates a corridor between a sino-atrial and the AV node. During 1992 and 1996, 70 patients (pts.), aged 27-67 (mean 47), with AF res istant to standard therapy, were referred for surgical treatment to our dep artment. Maze as an additional procedure was done in: 6 pts with Atrial Sep tal Defect (ASD), 2 pts with Isheamic heart disease (MD), 40 pts with Mitra l valve inssuficiency (MVI). Maze procedure was performed solely in 13 pts. In two pt, corridoring procedure was done. Normal sinus rhythm was restored in 52 (76%) pts from 1 to 5 weeks after su rgery. 3 pts. are in atrial tachycardia driven to the ventricles with AV block. In 5 pts. atrial fibrillation persisted but is easy pharmacologically control led. Six pacemakers were implanted for sick sinus syndrome postoperatively. No serious surgical complications were noted. The improvement of the cardiac hemodynamic function occurred in all patient s with sinus rhythm restored (52). Mechanical function of the atria was doc umented with echo Doppler 2 to 6 weeks after the operation, and revealed go od, left and right, atrial contribution to the ventricular filling. The preliminary results of maze and corridoring procedures for sinus rhythm restoration in patients with refractory atrial fibrillation are encouraged .