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Related Experiment Videos

Autonomic denervation after the Maze procedure.

Stefan Lönnerholm1, Per Blomström, Leif Nilsson

  • 1Dept. of Cardiology, University Hospital, 751 85 Uppsala, Sweden. stefan.lonnerholm@card.uas.lul.se

Pacing and Clinical Electrophysiology : PACE
|April 25, 2003
PubMed
Summary

The Maze III procedure significantly reduces heart rate variability (HRV) components, indicating potential cardiac autonomic denervation. These effects persist long-term after surgery for atrial fibrillation (AF).

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Area of Science:

  • Cardiology
  • Autonomic Nervous System Regulation
  • Cardiac Surgery

Background:

  • The Maze III procedure is an extensive surgical treatment for atrial fibrillation (AF).
  • The impact of the Maze III procedure on autonomic regulation of heart rhythm is not well understood.
  • Previous research has not extensively studied heart rate variability (HRV) changes post-Maze III surgery.

Purpose of the Study:

  • To investigate the effects of the Maze III procedure on heart rate variability (HRV) in patients with AF.
  • To assess changes in autonomic regulation of heart rhythm early and late after Maze III surgery.
  • To compare HRV in patients with paroxysmal AF versus chronic AF after the procedure.

Main Methods:

  • A cohort of 17 patients (10 paroxysmal AF, 7 chronic AF) without other cardiac conditions was studied.

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  • 24-hour Holter recordings were obtained preoperatively, and at 2 months (early) and 7 months (late) post-surgery.
  • Time and frequency domain analyses of heart rate variability (HRV) components were performed.

    • Main Results:

    • All HRV components (SDNN, total power, LF power, HF power, LF:HF ratio) were markedly reduced early after the Maze III procedure compared to baseline.
    • These reductions in HRV components were largely maintained at 7 months post-surgery.
    • Total power showed a significant increase between early and late follow-up, but remained below baseline levels.

    Conclusions:

    • The Maze III procedure leads to a marked and sustained decrease in all HRV components, suggesting cardiac autonomic denervation.
    • The observed HRV pattern is consistent with significant alterations in autonomic regulation following Maze III surgery.
    • No significant differences in HRV components were noted between paroxysmal and chronic AF patients at late follow-up.