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Long-Term Results of Surgical Atrial Fibrillation Radiofrequency Ablation: Comparison of Two Methods
Song Yang1, Bo Mei1, Kangni Feng1
1The Second Cardiac Surgery Department of First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Insights
Surgical atrial fibrillation ablation using left atrial MAZE is as safe and effective as biatrial MAZE for patients undergoing cardiac surgery. Long-term results show comparable sinus rhythm maintenance rates between the two procedures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia often addressed during cardiac surgery.
- Radiofrequency ablation techniques aim to restore normal heart rhythm.
- Evaluating long-term outcomes of different surgical ablation strategies is crucial.
Purpose of the Study:
- To compare the long-term efficacy and safety of biatrial MAZE versus left atrial MAZE radiofrequency ablation in patients undergoing concomitant cardiac operations.
- To assess sinus rhythm maintenance rates and complication profiles between the two ablation approaches.
Main Methods:
- Retrospective study of 129 patients undergoing cardiac operations with surgical AF ablation from 2006-2015.
- Patients were divided into biatrial MAZE (94) and left atrial MAZE (35) groups.
- Propensity-score matching was used to create a balanced 2:1 cohort for comparison of outcomes.
Main Results:
- No significant difference in sinus rhythm maintenance rates at 6 months, 1, 6, and 8 years between biatrial and left atrial MAZE groups (e.g., 8-year rates: 58.8% vs. 50%, p>0.05).
- Similar complication rates and no permanent pacemaker implantations were observed in either group.
- Mortality rates were low in both groups (4.3% in biatrial MAZE, one death in left atrial MAZE).
Conclusions:
- Left atrial MAZE ablation is a safe and effective alternative to biatrial MAZE for patients with mitral valve disease requiring open cardiac surgery.
- Both surgical ablation techniques demonstrate comparable long-term efficacy in maintaining sinus rhythm.
Background:
This retrospective study aimed to evaluate the long-term results of two kinds of surgical atrial fibrillation radiofrequency ablations in concomitant cardiac operations.
Methods:
We enrolled 129 patients from January 2006 to December 2015 and performed cardiac operations concomitantly with surgical atrial fibrillation. The patients were divided into a biatrial MAZE group (94 patients) and a left atrial MAZE group (35 patients). A preoperative baseline was compared with intraoperative and postoperative data. Similarly, complications and follow-up results were compared. A matching process based on propensity-score was performed to equalise the potential prognostic factors in both groups and to formulate a balanced 2:1 matched cohort study.
Results:
There were four deaths (4.3%) in the biatrial MAZE group and one death in left atrial MAZE group due to multiple organ failures followed by low cardiac output. No permanent pacemaker implantations were used in either group. The sinus rhythm maintenance rates at the 6-month, 1-year, 6-year and 8-year follow-ups between the biatrial MAZE group and the left atrial MAZE group were not significantly different (84.7%, 83.3%, 67.3%, and 58.8% vs. 84.9%, 77.4%, 61.1%, and 50%, p>0.05). Similarly, between the propensity-score matched groups, there were no significant differences.
Conclusion:
The left atrial MAZE ablation for the patients with mitral valve diseases who needed open cardiac operation was safe and effective when compared with the biatrial MAZE ablation group.
