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Maze atrial fibrillation

Dong Seop Jeong, Kiick Sung, Wook Sung Kim, Carriere Kc, Pyo Won Park
BACKGROUND: Currently, two types of cryoprobes are available: N2 O-based and argon gas-based. However, few studies have compared the outcomes obtained with these two cryoprobe types. The aim of this study was to compare the early outcomes of a concomitant maze procedure using N2 O-based cryoablation (the N2 O group) versus argon gas-based cryoablation (the Argon group) in patients with persistent atrial fibrillation (AF). METHODS: This study was a single-center, prospective, randomized controlled clinical trial...
February 1, 2019: Annals of Thoracic Surgery
Roger A Winkle, William Fleming, R Hardwin Mead, Gregory Engel, Melissa H Kong, Jonathan Salcedo, Rob A Patrawala, Luis Castro, Vincent Gaudiani
PURPOSE: To compare findings in patients undergoing atrial fibrillation(AF) and/or atrial flutter(AFl) ablation after failed cut and sew (CS) vs. non-cut and sew (NCS) surgical maze. METHODS: We compared 10 patients with prior CS to 25 with prior NCS maze undergoing catheter ablation after failed maze. RESULTS: Patient demographics: Age 68.3 ± 8.7 CS vs. 68.2 ± 9.2 NCS(P = 0.977), male 70% CS vs. 72% NCS(P = 1.000), LA size 5...
January 31, 2019: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Charlotte van Laar, Mohamed Bentala, Timo Weimar, Nicolas Doll, Martin J Swaans, Sander G Molhoek, Frederik N Hofman, Johannes Kelder, Bart P van Putte
Aims: To perform a systematic outcome analysis in order to provide cardiologists and general pactitioners with more adequate information to guide their decision making regarding rhythm control. Totally thoracoscopic maze (TTmaze) for the treatment of atrial fibrillation (AF) is recommended as a Class 2a indication mainly based on single centre studies including small patient cohorts and inconsistent lesion sets. Methods and results: We studied consecutive patients undergoing TTmaze in three European referral centres (2012-15)...
January 25, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ünsal Vural, Ahmet Yavuz Balcı, Ahmet Arif Ağlar, Mehmet Kızılay
OBJECTIVE: The effects of energy source on the maintenance of sinus rhythm and the contribution of demographic characteristics to the case selection in patients submitted to ablation performed concurrently with mitral valve surgery were analyzed. METHODS: Cryothermal (n=42; 43.8%) and radiofrequency (n=54; 56.3%) energy were employed in 96 patients submitted to mitral valve replacement and Cox maze IV procedure. Patients were called for control visits between 15 days and 12 months after discharge...
November 2018: Brazilian Journal of Cardiovascular Surgery
Niv Ad, Sari D Holmes, Anthony J Rongione, Vinay Badhwar, Lawrence Wei, Lisa M Fornaresio, Paul S Massimiano
OBJECTIVE: Newly published guidelines made the highest level recommendation for surgical treatment for atrial fibrillation. However, the number of patients without a mitral valve procedure with atrial fibrillation who are treated with concomitant surgical ablation is still low (15%-25%), because surgeons are reluctant to perform procedures in patients who would not otherwise require left atriotomy. The purpose of this study was to compare the outcomes of concomitant Cox maze with and without mitral valve procedures...
November 22, 2018: Journal of Thoracic and Cardiovascular Surgery
Hiroyuki Itaya, Chikashi Aoki, Ryo Hatanaka, Ikuo Fukuda
Left atrial appendage aneurysm (LAAA) is a rare congenital heart anomaly that frequently becomes apparent after middle age. We report a case of LAAA in a 63-year-old woman with stroke. After stabilization of ischemic cerebral stroke, the patient underwent left atrial appendectomy with full maze procedure and tricuspid annuloplasty under cardiac arrest with cardiopulmonary bypasss. She has been living a healthy life without anticoagulants postoperatively. Resection and the full-maze procedure is an efficacious and durable procedure for LAAA with chronic atrial fibrillation...
December 18, 2018: General Thoracic and Cardiovascular Surgery
Eugene H Blackstone, Helena L Chang, Jeevanantham Rajeswaran, Michael K Parides, Hemant Ishwaran, Liang Li, John Ehrlinger, Annetine C Gelijns, Alan J Moskowitz, Michael Argenziano, Joseph J DeRose, Jean-Phillipe Couderc, Dan Balda, François Dagenais, Michael J Mack, Gorav Ailawadi, Peter K Smith, Michael A Acker, Patrick T O'Gara, A Marc Gillinov
OBJECTIVE: To use novel statistical methods for analyzing the effect of lesion set on (long-standing) persistent atrial fibrillation (AF) in the Cardiothoracic Surgical Trials Network trial of surgical ablation during mitral valve surgery (MVS). METHODS: Two hundred sixty such patients were randomized to MVS + surgical ablation or MVS alone. Ablation was randomized between pulmonary vein isolation and biatrial maze. During 12 months postsurgery, 228 patients (88%) submitted 7949 transtelephonic monitoring (TTM) recordings, analyzed for AF, atrial flutter (AFL), or atrial tachycardia (AT)...
January 2019: Journal of Thoracic and Cardiovascular Surgery
Anthony P Brennan, William Martin, Heath Adams, Michael Yii
BACKGROUND: The Cox-Maze IV procedure is a proven surgical treatment for atrial fibrillation (AF). Previous studies on the procedure and its effect on left atrial mechanical function have yielded mixed results. METHODS: Sixty-four patients underwent Cox-Maze IV at St Vincent's Hospital, Melbourne between March 2010 and May 2016. Baseline characteristics were collected and outcomes assessed including rhythm analysis. Preoperative and postoperative transthoracic echocardiograms were reviewed...
November 30, 2018: Heart, Lung & Circulation
Ali J Khiabani, Taylan Adademir, Richard B Schuessler, Spencer J Melby, Marc R Moon, Ralph J Damiano
Untreated atrial fibrillation is associated with an increased risk of all-cause mortality and morbidity. Despite the current guidelines recommending surgical ablation of atrial fibrillation at the time of coronary artery bypass surgery, most patients with concomitant atrial fibrillation and coronary artery disease do not receive surgical ablation for their atrial fibrillation. This review reports the efficacy of different surgical ablation techniques used for the treatment of atrial fibrillation during coronary artery bypass...
November 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Marek P Ehrlich, Guenther Laufer, Iuliana Coti, Markus Peter, Martin Andreas, Guenter Stix, Niv Ad
OBJECTIVE: The study objective was to study the electrophysiologic mechanism of atrial fibrillation using a noninvasive, beat-by-beat, 3-dimensional mapping technique in patients with persistent and long-standing persistent atrial fibrillation undergoing concomitant surgical ablation. METHODS: In this pilot trial, 10 patients (6 male; mean age, 70 ± 10 years) with persistent atrial fibrillation were mapped preoperatively with a noninvasive surface system (ECVUE, CardioInsight, Medtronic Inc, Minneapolis, Minn)...
September 25, 2018: Journal of Thoracic and Cardiovascular Surgery
Uma N Srivatsa, Guibo Xing, Ezra Amsterdam, Nipavan Chiamvimonvat, Nayereh Pezeshkian, Dali Fan, Richard H White
Background: Catheter ablation (ABL) for non-valvular (NV) atrial fibrillation (AF) improves rhythm control. Our aim was to compare re-hospitalization for heart failure (HF), acute coronary syndrome (ACS), or recurrent AF among patients with NVAF who underwent ABL versus controls. Methods: From the Office of Statewide Planning and Development (OSHPD) database, we identified all patients who had at least one hospitalization for AF between 2005-2013. Patients who subsequently underwent ABL were compared to controls (up to fivematched controls by age, sex and duration of AF between diagnosis and time of ABL)...
June 2018: Journal of Atrial Fibrillation
Y Tony Yang, Jesse Ortendahl
OBJECTIVES: Data related to the cost effectiveness of surgical interventions and catheter ablation are sparse. This model-based analysis assessed the clinical and economic trade-offs involved in using catheter ablation or the Cox maze procedure in treating patients with atrial fibrillation. METHODS: A deterministic model was developed to project one-year and lifetime health-related outcomes, costs, quality-adjusted life years (QALYs), and cost effectiveness of each treatment in patients with atrial fibrillation...
November 9, 2018: Current Medical Research and Opinion
Min Soo Cho, Ran Heo, Xin Jin, Jung-Bok Lee, Sahmin Lee, Dae-Hee Kim, Joon Bum Kim, Jun Kim, Sung-Ho Jung, Suk Jung Choo, Jong-Min Song, Gi-Byoung Nam, Kee-Joon Choi, Duk-Hyun Kang, Cheol Hyun Chung, Jae Won Lee, You-Ho Kim, Jae-Kwan Song
Background To characterize the development of sick sinus syndrome ( SSS ) after the additive maze procedure ( MP ) during mitral valve surgery. Methods and Results Follow-up data (median, 3.6 years) of 750 patients with a prevalence of rheumatic cause of 57.6% were analyzed. SSS occurred in 35 patients with a time-dependent increase: the incidence rates at 1, 2, and 4 years after surgery were 2.9%, 3.7%, and 4.3%, respectively. The additive MP showed higher risks of SSS development (hazard ratio, 7.44; 95% confidence interval, 3...
October 2, 2018: Journal of the American Heart Association
Hiroki Konishi, Koji Fukuzawa, Shumpei Mori, Kunihiko Kiuchi, Ken-Ichi Hirata
A 69-year-old man, who had undergone surgery for mitral and tricuspid regurgitation with the Maze procedure for paroxysmal atrial fibrillation, was admitted with an episode of syncope due to sick sinus syndrome. Three days after implantation of a dual-chamber pacemaker (Accent MRI™, St. Jude Medical Inc.,), ventricular pacing on T-wave was recorded multiple times. St. Jude Medical Inc. pacemakers have a unique additional algorithm, called premature ventricular contraction response, related to preventing pacemaker-mediated tachycardia...
October 2018: Journal of Arrhythmia
Yosuke Ishii
Fundamental procedure of arrhythmia surgery is to bock conduction of macro-reentry or focal activation. Traditional "cut and sew" technique is effective to make a conduction block without any special devices although it is time consuming and there is some bleeding risk. Surgical ablation devices are easily able to make a conduction block during surgery. It could undergo the minimally invasive cardiovascular surgery (MICS) -maze procedure through the right mini thoracotomy. It is most important to make complete conduction block because incomplete ablation causes residual conduction, resulting in recurrence of atrial fibrillation or atrial tachycardia...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Shun-Ichiro Sakamoto, Atsushi Hiromoto, Yosuke Ishii, Takashi Sasaki, Yasuo Miyagi, Takashi Nitta
PURPOSE: We examined the outcome of modified-maze procedures reflecting a single-center strategy in the treatment of atrial fibrillation (AF) associated with atrial septal defect (ASD) in adults. METHODS: A retrospective chart review was performed for 29 patients who underwent surgical ASD closure and 2 types of maze procedures (full and simplified maze procedures) for AF. The outcome related to the each procedure was examined. A Cox proportional hazards analysis was performed to assess the independent predictors of AF and atrial tachycardia (AT) recurrence...
September 3, 2018: Surgery Today
N Ma, J Mei, R X Lu, Z L Jiang, M Tang, F B Ding
Objective: To evaluate the efficacy of Mei mini maze procedure for treating atrial fibrillation (AF) patients with previously failed catheter ablation. Methods: Between August 2010 and May 2016, 48 AF (8 proximal AF, 15 persistent AF and 25 long-standing persistent AF) patients (29 males, 19 females, mean age: (62.5±7.3) years old) with previously 1-3 failed catheter ablation results were treated with Mei mini maze procedure in our department. Under thoracoscopic assistance, the procedure was performed through three ports on left chest wall, pulmonary vein isolation and ablations of the roof and posterior wall of left atrium was made by bipolar radiofrequency ablation...
August 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
James L Cox, Andrei Churyla, S Chris Malaisrie, Jane Kruse, Duc Thinh Pham, Olga N Kislitsina, Patrick M McCarthy
The initial surgical attempts to treat atrial fibrillation (AF) were isolation procedures designed to confine the arrhythmia to a specific area of the heart for relief of symptoms. The first surgical attempt to ablate AF was unsuccessful but was quickly followed by the Maze-I procedure on September 25, 1987. Because of several adverse sequelae of the Maze-I procedure, it was sequentially modified to the Maze-II and then Maze-III procedures. The Maze-IV procedure was introduced some 10 years later; these are the only 4 procedures that adhere to the concept of a maze pattern of lesions to ablate AF and leave both atria capable of being activated during normal sinus rhythm...
November 2018: Canadian Journal of Cardiology
James L Cox, Andrei Churyla, S Chris Malaisrie, Duc Thinh Pham, Jane Kruse, Olga N Kislitsina, Patrick M McCarthy
BACKGROUND: Catheter ablation (CA) for long-standing persistent atrial fibrillation (LSPAF) is suboptimal and open surgical ablation, while more successful, is too invasive to be a first-line therapy. Less invasive hybrid procedures that combine thoracoscopic surgery (TS) with CA have been only marginally more successful for LSPAF than CA alone. METHODS: Joint hybrid procedures for LSPAF are based on the assumption that AF surgery and CA procedures can be guided by intraoperative mapping...
August 14, 2018: Annals of Thoracic Surgery
Charlotte van Laar, Niels J Verberkmoes, Hendrik W van Es, Thorsten Lewalter, Gan Dunnington, Stephen Stark, James Longoria, Frederik H Hofman, Carolyn M Pierce, Dipak Kotecha, Bart P van Putte
OBJECTIVES: This study sought to document the closure rate, safety, and stroke rate after thoracoscopic left atrial appendage (LAA) clipping. BACKGROUND: The LAA is the main source of stroke in patients with atrial fibrillation, and thoracoscopic clipping may provide a durable and safe closure technique. METHODS: The investigators studied consecutive patients undergoing clipping as part of a thoracoscopic maze procedure in 4 referral centers (the Netherlands and the United States) from 2012 to 2016...
July 2018: JACC. Clinical Electrophysiology
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