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Left Versus Bi-Atrial Intraoperative Saline-Irrigated Radiofrequency Modified Maze Procedure for Atrial Fibrillation

  • Published:
Cardiac Electrophysiology Review

Abstract

Background: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures.

Material and method: During a period of two years, 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure.

Patients underwent either a bi-atrial (n = 48) or left atrial (n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 ± 11 years in bi-atrial group and 54 ± 9 years in left atrial group.

Results: Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2%, pacemaker: 20.8%), (Left atrial group: sinus: 82.5%, pacemaker: 17.5%) (p > 0.05). During the last follow-up, sinus rhythm was maintained in 79.6% of cases in bi-atrial group, while this rate was 75.6% in left atrial group (p > 0.05).

Conclusion: Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Kadir Has University, Florence Nightingale Hospital, Istanbul, Turkey

    Mustafa Guden, Belhhan Akpinar, Baris Caynak, Cavlan Turkoglu, Zeki Ozyedek, Ilhan Sanisoglu & Ertan Sagbas

  2. Department of Cardiology, Kadir Has University, Florence Nightingale Hospital, Istanbul, Turkey

    Saide Aytekin

  3. School of Nursing, Kadir Has University, Florence Nightingale Hospital, Istanbul, Turkey

    Seher Deniz Oztekin

Authors
  1. Mustafa Guden
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  2. Belhhan Akpinar
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  3. Baris Caynak
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  6. Ilhan Sanisoglu
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  7. Ertan Sagbas
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Guden, M., Akpinar, B., Caynak, B. et al. Left Versus Bi-Atrial Intraoperative Saline-Irrigated Radiofrequency Modified Maze Procedure for Atrial Fibrillation. Card Electrophysiol Rev 7, 252–258 (2003). https://doi.org/10.1023/B:CEPR.0000012393.09666.26

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  • DOI: https://doi.org/10.1023/B:CEPR.0000012393.09666.26

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