Results of maze surgery for lone paroxysmal atrial fibrillation

Background-If drug refractoriness to paroxysmal atrial fibrillation (PAF) o ccurs, arrhythmia surgery that involves channelling and the exclusion of sp ecific atrial areas can abolish atrial fibrillation. The purpose of this st udy was to establish the effectiveness and safety of maze III surgery to ab olish PAF, Methods and Results-Surgery was performed in 41 selected patients who had l ong-standing, symptomatic, drug-refractory, lone PAF, At discharge, 35 pati ents (85%) were arrhythmia free, and 6 patients (15%) showed PAF and paroxy smal atrial tachycardia. Death or stroke did not occur during a mean follow -up of 31+/-16 months. At the end of follow-up, 39 patients (95%) had no PA F; however, in 2 patients (5%), PAF persisted and eventually required His b undle ablation and pacing. Three months after surgery, nodal escape rhythm was observed in only 1 patient, whereas sick-sinus syndrome emerged late af ter surgery in 2 patients. Antiarrhythmic drugs were used in 20% of patient s during follow-up. The quality of life improved markedly after surgery and remained unchanged afterward. Echocardiographic findings did not alter, bu t exercise capacity increased. Conclusions-This pilot study demonstrates the effectiveness and safety of m aze III surgery for lone PAF, In patients without sick-sinus syndrome, this intervention offers a sensible alternative to His bundle ablation and life long pacemaker dependency.