Modified maze procedure for atrial fibrillation as an adjunct to elective cardiac surgery : predictors of mid-term recurrence and echocardiographic follow-up

The radiofrequency maze procedure achieves sinus rhythm in 45%\u201395% of patients treated for atrial fibrillation. This retrospective study evaluates mid-term results of the radiofrequency maze\u2014performed concomitant to elective cardiac surgery\u2014to determine sinus-rhythm predictive factors, and describes the evolution of patients\u2019 echocardiographic variables. From 2003 through 2011, 247 patients (mean age, 64 \ub1 9.5 yr) with structural heart disease (79.3% mitral disease) and atrial fibrillation underwent a concomitant radiofrequency modified maze procedure. Patients were monitored by 24-hour Holter at 3, 6, 12, and 24 months, then annually. Eighty-four mitral-valve patients underwent regular echocardiographic follow-up. Univariate and multivariate analysis for risk factors of maze failure were identified. The in-hospital mortality rate was 1.2%. During a median follow-up of 39.4 months, the late mortality rate was 3.6%, and pacemaker insertion was necessary in 26 patients (9.4%). Sinus rhythm was present in 63% of patients at the latest follow-up. Predictive factors for atrial fibrillation recurrence were arrhythmia duration (hazard ratio [HR]=1.296, P=0.045) and atrial fibrillation at hospital discharge (HR=2.03, P=0.019). The monopolar device favored maze success (HR=0.191, P