[Cox-maze III procedure for atrial fibrillation. A preliminary study]

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology

Background:

• Atrial fibrillation is a common arrhythmia often treated surgically.
• Mitral valve disease frequently coexists with atrial fibrillation, requiring combined surgical approaches.

Purpose of the Study:

• To compare the efficacy of the Cox-maze III (cut-and-sew) procedure versus the Cox-maze IV (radiofrequency ablation) procedure for treating atrial fibrillation.
• To evaluate outcomes in patients undergoing concomitant mitral valve surgery.

Main Methods:

• A comparative study involving 50 patients with atrial fibrillation longer than 1 year undergoing mitral valve surgery.
• Patients were divided into two groups: Cox-maze III (n=36) and Cox-maze IV (n=14).
• Follow-up assessed freedom from atrial fibrillation at 6 months.

Main Results:

• No significant differences in baseline or operative characteristics were observed between the groups.
• Operative mortality was 2 cases in the Cox-maze III group and 0 in the Cox-maze IV group (P=0.9).
• Freedom from atrial fibrillation at 6 months was significantly higher in the Cox-maze III group (92%) compared to the Cox-maze IV group (53%) (P<.001).

Conclusions:

• The standard Cox-maze III (cut-and-sew) procedure demonstrated superior efficacy in eliminating atrial fibrillation compared to the Cox-maze IV procedure utilizing bipolar radiofrequency ablation.
• These findings suggest the Cox-maze III technique may be preferred for patients with concomitant mitral valve disease and atrial fibrillation.