Atrial tachyarrhythmias after the maze procedure: incidence and prognosis
Yosuke Ishii1, Marye J Gleva, M Carolyn Gamache
1Washington University School of Medicine, Division of Cardiothoracic Surgery, St. Louis, Mo, USA.
Circulation
|September 15, 2004
Summary
Atrial tachyarrhythmias (ATA) affect 43% of patients post-Maze procedure, typically occurring within 8 days and resolving within 3 weeks. Early ATA does not predict late atrial fibrillation recurrence.
Area of Science:
- Cardiac Surgery
- Electrophysiology
- Arrhythmology
Background:
- The Maze procedure is effective for restoring normal sinus rhythm.
- Atrial tachyarrhythmias (ATA) are frequent early complications following Maze surgery.
- Understanding ATA's incidence and natural history post-Maze is crucial.
Purpose of the Study:
- To determine the incidence of early postoperative ATA after the Maze procedure.
- To describe the natural history and resolution patterns of ATA.
- To investigate the relationship between early ATA and late atrial fibrillation recurrence.
Main Methods:
- Retrospective review of medical records for 200 patients undergoing Maze procedures (I, II, III) from 1987-2002.
- Analysis of all early postoperative ATA episodes within 30 days of surgery.
- Independent review of postoperative 12-lead electrocardiograms by two electrophysiologists.
Main Results:
- ATA occurred in 86 patients (43%), with atrial fibrillation (AF) in 59%, atrial flutter (AFL) in 14%, and both in 27%.
- Peak incidence of ATA was on postoperative day 8; average duration was 5.7 days.
- Late AF recurrence (>1 year) showed no significant difference between patients with or without early ATA (7.0% vs 8.8%, P=0.8).
Conclusions:
- Early postoperative ATA is common (43%) after Maze procedures, primarily occurring within 8 days.
- Most ATA episodes resolve within approximately 3 weeks.
- The presence of early postoperative ATA does not correlate with late recurrence of atrial fibrillation.
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