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Capstone

Concomitant Modified Maze Surgery: Long and Short Efficacy

1 August 2006

Abstract

Context: There are various nonphannacologic procedures that are used to prevent recurrent atrial fibrillation. The primary focus of this study is review the efficacy of one of the surgical nonphannacologic procedures called a modified Maze procedure.

Objective: This study will evaluate the reoccurrence of atrial fibrillation after a modified Maze procedure has been performed as adjunctive therapy in patients who have had surgery for other cardiac problems(i.e.: coronary artery disease, valve replacement or repair, congenital heart disease).

Design, Setting, and Patients: A total of 197 patients received the modified Maze surgical procedure from Dr. Jeffrey Swanson from 7/24/01-12/31105. 177 patients were asked to complete a survey regarding their cardiac health, current medications and current heart rhythm. XX responded with surveys. XX had follow-up EKGs/cardiac consults to confirm current heart rhythm to assess the success rate of the modified Maze procedure.

Main Outcome Measure: Primary measure is the short and long term recurrence of AF status post modified maze procedure. Secondary outcome was to review age, gender and BMI in relation to AF.

Results: During the mean follow-up period of 27 months (range, 3 to 52 months) 195 were reviewed for current sinus rhythm. 21 patients (10.78%) died since surgery. Of 125 responses (71 %) to follow-up survey 61 had current documented heart rhythm. In the documented group 74% were in restored sinus rhythm, 18% were confirmed atrial fibrillation and 8.2% were in sinus rhythm while taking an antiarrhythmic medication.

Conclusions: The modified maze procedure using radio frequency ablation/isolation significantly increases the rate of return to sinus rhythm in short term and long term postoperatively. Based on efficacy this procedure is justified as a concomitant procedure during open heart surgery.


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