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Left ventricular dysfunction in atrial fibrillation: restoration of sinus rhythm by the Cox-maze procedure

John M Stulak1, Joseph A Dearani, Richard C Daly

  • 1Division of Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

The Annals of Thoracic Surgery
|July 26, 2006
PubMed

Insights

The Cox-maze procedure effectively treats tachycardia-induced cardiomyopathy caused by atrial flutter or fibrillation. Restoring sinus rhythm significantly improves left ventricular function and overall patient status.

Area of Science:

  • Cardiology
  • Cardiac Surgery

Background:

  • Atrial flutter/fibrillation with rapid ventricular response can cause left ventricular dysfunction.
  • The Cox-maze procedure aims to restore sinus rhythm.
  • Limited data exists on the Cox-maze procedure's impact on tachycardia-induced cardiomyopathy.

Purpose of the Study:

  • To evaluate the effectiveness of the Cox-maze procedure in patients with tachycardia-induced cardiomyopathy.
  • To assess the impact of restoring sinus rhythm on left ventricular function.

Main Methods:

  • The Cox-maze procedure was performed on 443 patients between 1993 and 2002.
  • Ninety-nine patients had atrial flutter/fibrillation without other heart conditions.
  • Thirty-seven of these patients had reduced left ventricular function.

Main Results:

  • The Cox-maze procedure successfully eliminated atrial flutter/fibrillation in all but one patient.
  • Significant improvement in left ventricular ejection fraction was observed, particularly in severely impaired patients.
  • Functional status improved, correlating with enhanced cardiac function.

Conclusions:

  • Atrial flutter/fibrillation can be a primary cause of left ventricular dysfunction.
  • The Cox-maze procedure offers a significant benefit in improving systolic function and functional status by restoring sinus rhythm.
Abstract

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