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Efficacy of the maze procedure for atrial fibrillation associated with atrial septal defect
Hunbo Shim1, Ji-Hyuk Yang, Pyo-Won Park
1Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Insights
The maze procedure combined with atrial septal defect (ASD) closure is a safe and effective treatment for elderly patients experiencing atrial fibrillation (AF). This approach successfully restores sinus rhythm in a high percentage of patients, significantly improving outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a frequent complication in elderly individuals with atrial septal defect (ASD).
- The maze procedure is a surgical treatment for cardiac arrhythmias.
Purpose of the Study:
- To evaluate the efficacy of the maze procedure in elderly patients with ASD and AF.
- To assess the safety and rhythm control outcomes of concomitant maze procedure and ASD closure.
Main Methods:
- A cohort of 46 patients underwent concomitant maze procedure and ASD closure between 2000 and 2011.
- Follow-up included regular electrocardiography for up to 3.2±2.5 years.
- Exclusion criteria involved right-sided maze procedures and loss to follow-up.
Main Results:
- No early mortality was observed post-operation.
- One year post-surgery, 55.3% of patients achieved sinus rhythm without antiarrhythmic drugs; 92.1% achieved sinus rhythm with medication.
- Long-term freedom from AF recurrence was high, with rates remaining above 68% at 5 years.
Conclusions:
- Concomitant maze procedure and ASD closure is a safe and effective strategy.
- This combined approach successfully restores sinus rhythm in patients with ASD and AF.
- The procedure offers significant long-term benefits for rhythm control.
Background:
Atrial fibrillation (AF) is a common complication in elderly patients with atrial septal defect (ASD). The purpose of this study was to examine the efficacy of the maze procedure in these patients.
Materials And Methods:
Between February 2000 and May 2011, 46 patients underwent the maze procedure as a concomitant operation with ASD closure. Three patients who underwent a right-sided maze were excluded, and one patient was lost to follow-up. The mean follow-up duration was 3.2±2.5 years. Electrocardiography was performed 1 month, 3 months, 6 months, and 1 year after surgery, and checked annually after that.
Results:
AF persisted in 4 patients after surgery. One year after surgery, among 38 patients, 55.3% remained in sinus rhythm without antiarrhythmic drugs. However, when including the patients who took antiarrhythmic drugs, 92.1% were in sinus rhythm. Freedom from AF recurrence at 3 months, 6 months, 1 year, 2 years, 3 years, and 5 years after surgery were 97.4±2.6, 94.4±3.8, 91.2±4.9, 87.8±5.8, 79.5±7.6, and 68.2±12.4, respectively. There was no early mortality after operation.
Conclusion:
Concomitant treatment with the maze procedure and ASD closure is safe and effective for restoring the sinus rhythm.
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