A modified Cox maze IV procedure: a simpler technique for the surgical treatment of atrial fibrillation.

Interact Cardiovasc Thorac Surg

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China

Published: December 2016

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Article Abstract

Objectives: To determine the effectiveness of a simplified surgical treatment method for atrial fibrillation (AF).

Methods: 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.

Results: 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.

Conclusions: 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.

Clinical Trials Registration Id: ChiCTR-TRC-12002742.

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http://dx.doi.org/10.1093/icvts/ivw256DOI Listing

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