Open AccessEffectiveness of the Cox Maze-IV Procedure in Cardiac Surgery Patients With Atrial Fibrillation
Author(s) -
Н.А. Трофимов,
А. П. Медведев,
В. Е. Бабокин,
A.V. Nikolsky,
И П Ефимова,
В В Плечев,
Д. В. Плечева,
S V Babokina,
V.Yu. Kashin,
N. Kh. Zhamlikhanov,
Dmitry Egorov
Publication year - 2020
Publication title -
kardiologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.159
H-Index - 16
eISSN - 2412-5660
pISSN - 0022-9040
DOI - 10.18087/cardio.2020.5.n991
Subject(s) - medicine , atrial fibrillation , amiodarone , cardiology , sinus rhythm , cardiac surgery , heart failure , incidence (geometry) , surgery , anesthesia , physics , optics
Aim Analyzing a 5-year experience of surgical treatment of cardiosurgical patients with atrial fibrillation (AF). Material and methods The study analyzed results of surgical treatment with extracorporeal circulation in 132 patients with AF who underwent the Maze-IV procedure using a radiofrequency ablator with transmurality feedback from 2013 through 2018. Results Two fatal outcomes were observed in the study group. These outcomes took place in the early postoperative period and were associated with progressive acute heart failure in patients with repeated surgery for mitral valve restenosis. 61.2% of the patients had no AF. Recurrent AF was observed during the first three years after surgery in association with withdrawal of the antiarrhythmic medication, which confirmed a need for long-term antiarrhythmic therapy. Analysis of risk factors for AF relapse identified significant predictors, including left ventricular dilatation larger than 5.5 cm at baseline and more than two-year duration of a history of arrhythmias. Conclusion The Maze-IV procedure proved an effective and safe method of surgical treatment in AF patients with acquired heart defects and ischemic heart disease, which allowed maintaining sinus rhythm in 61.2% of patients for 5 years. Preventive amiodarone saturation reduced the risk of AF relapse by 24.2 % (p=0.038) and incidence of postoperative arrhythmic complications by 34.9 % (p=0.008) in cardiosurgical patients.