Long-term follow-up after the mini-maze procedure.

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Atrial fibrillation (AF) significantly increases morbidity and mortality.
• The complex Cox maze III procedure is not routinely performed.
• Long-term results of AF surgical variants like mini-maze require further investigation.

Purpose of the Study:

• To evaluate the early and long-term efficacy of the mini-maze procedure for chronic symptomatic atrial fibrillation.
• To assess mortality rates, survival, and restoration of sinus rhythm post-procedure.
• To identify predictors for successful sinus rhythm restoration and pacemaker implantation.

Main Methods:

• A mini-maze procedure was performed on 77 patients with chronic symptomatic AF between November 1995 and May 2002.
• Patients underwent electrophysiological, MRI, echocardiographic, and ECG evaluations at 3 and 12 months.
• A mean follow-up of 50 months included a standard patient questionnaire.

Main Results:

• Early and late mortality rates were 1.2% and 9.3%, respectively, with 5-year actuarial survival at 87%.
• Left bundle branch block was an independent risk factor for late death.
• Seventy-one percent of patients achieved sinus rhythm or atrial pacing; predictors for sinus rhythm included absence of mitral insufficiency and larger left atrium.

Conclusions:

• The mini-maze procedure demonstrates satisfactory early and long-term results for atrial fibrillation treatment.
• Prophylactic biventricular pacemakers may reduce late mortality in patients with left bundle branch block.
• Curing atrial fibrillation is essential for improving long-term patient survival.