Radiofrequency modified maze in patients with atrial fibrillation undergoing concomitant cardiac surgery

Objective: In the majority of patients with chronic atrial fibrillation the arrhythmia will persist after correction of the underlying structural abno rmality. The maze procedure is an effective surgical method to eliminate at rial fibrillation and to restore atrial contractility. Methods: In this study we used radiofrequency energy to create lines of con duction block in both atria during cardiac surgery as a modification of the maze III procedure. One hundred twenty-two patients with atrial fibrillati on for at least 1 year and structural heart disease underwent open heart op eration and a radiofrequency modified maze procedure. Results: In 108 (89%) of 122 patients mitral valve surgery was performed, a nd in this group 86 patients (80%) underwent 121 concomitant procedures. Fo urteen patients (11%) underwent cardiac surgery not involving the mitral va lve. The additional crossclamp time required for the left atrial part of th e radiofrequency modified maze procedure was 14+/-3 minutes. The in-hospita l mortality rate was 4.1%. The overall 39-month survival was 90%, and freed om of atrial flutter or atrial fibrillation was 78.5% +/- 5.1%. Eighty-nine survivors with sinus, atrial rhythm, or atrioventricular sequential pacema ker had Doppler echocardiography, and right atrial transport function was d ocumented in 83% and left atrial transport function in 77% of patients. Conclusion: We concluded that the radiofrequency modified maze procedure as an adjunctive procedure is safe, time-sparing, and effective in eliminatin g atrial fibrillation and restoring atrial transport function.