Introduction of transesophageal electrocardiography to surgery for continuous atrial fibrillation

The purpose of this study was to assess esophageal electrocardiographic characteristics of atrial fibrillation, and compare these results with outcomes of surgical interventions. We analyzed 158 patients, who were operated on for valvular heart disease and continuous atrial fibrillation. Recently, 57 patients were examined by transesophageal electrocardiography. The results of surgery and the relation between transesophageal electrocardiography and restoration to a sinus rhythm were analyzed. One-hundred and twenty-three patients (77.8%) had been restored to a sinus rhythm in the early stage and 116 patients (73.9%) in the late stage after operation. The restoration rate to a sinus rhythm was 77.0% in the maze procedure and 81.3% in pulmonary vein isolation. According to the form of f-waves obtained from the transesophageal electrocardiography, in patients with a regular f-wave pattern, the sinus rhythm was completely restored after maze or pulmonary vein isolation. By using transesophageal electrocardiography preoperatively, it may be possible to decide before surgery which operative procedure should be used, maze or pulmonary vein isolation.