Surgical stratification of patients with atrial fibrillation secondary to organic cardiac lesions

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
A T KawaguchiY Kawashima

Abstract

While the maze procedure does not always eliminate atrial fibrillation (AF) secondary to organic cardiac lesions, concomitant performance of the procedure is associated with increased surgical complexity and potential risks. To stratify the surgical approach for patients with AF secondary to underlying cardiac lesions, we analyzed 24 preoperative and perioperative variables in 115 consecutive patients with AF undergoing a modified maze procedure combined with valvular intervention (101), repair of congenital anomalies (13) and coronary revascularization (1). Patients who remained in AF (18) compared to patients with restored atrial rhythm (97), had a higher incidence of giant left atrium (56% vs 10%, P < 0.0001), larger cardiothoracic ratio (70 +/- 13 vs 62 +/- 8%, P = 0.001) and left atrial dimension (64 +/- 12 vs 55 +/- 12 mm, P = 0.004), a longer history of AF (13.7 +/- 6.8 vs 8.3 +/- 6.9 years, P = 0.003) and lower f-wave voltage (0.10 vs 0.15 mV, P = 0.004). Multivariate logistic regression analysis of 24 preoperative and perioperative variables identified the presence of giant left atrium, cardiothoracic ratio and age at operation as the significant risk factors predisposing patients to persistent postoperative AF. Retros...Continue Reading

Citations

Mar 28, 2001·The Annals of Thoracic Surgery·O A García-VillarrealR Argüero
May 9, 2003·The Annals of Thoracic Surgery·N Madhu SankarKotturathu M Cherian
Aug 6, 1998·The Annals of Thoracic Surgery·N M Sankar, A E Farnsworth
Jul 6, 2000·The Annals of Thoracic Surgery·S FukunagaS Aoyagi
Jan 25, 2008·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Niv Ad
Mar 18, 2017·Khirurgiia·P V LednevA I Katkov
Dec 20, 2018·BMC Cardiovascular Disorders·Zan MitrevRodney Alexander Rosalia

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