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[Combined endocardial and epicardial radiofrequency modified Maze procedure in the treatment of atrial fibrillation].
Zhonghua Wai Ke Za Zhi. 2007 Mar 15; 45(6):415-8.ZW

Abstract

OBJECTIVE

To evaluate the effectiveness of the combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure for the treatment of atrial fibrillation (AF).

METHODS

During a period of 3 years, 295 patients with AF having concomitant cardiac surgery underwent the procedure. Patients underwent either the endocardial and epicardial group (n=185) or the endocardial group (n=110) radiofrequency ablation. There were 124 males, 171 females with a mean age of (52 +/- 11) year old. Mean duration of preoperative AF was 36 +/- 43 months. And about 90.8 percent valve pathology was rheumatic. Valve operation was performed in 289 patients, coronary artery bypass graft surgery in 19 patients and congenital heart disease operation in 6 patients respectively. Follow-up for the whole patients ranged from 3 to 47 months (mean 28 +/- 5 months).

RESULTS

Ten patients died postoperatively (3.4%). Four patients died of low cardiac output, five patients died of multisystem and organ failure, one patient died of cerebral hernia. There were 2 patients died of nerves system complication during follow-up. At the end of the procedure 228 patients (77.3%) were sinus rhythm, including 78 patients (70.9%) in endocardial group while 150 patients (81.1%) in endocardial and epicardial group (P<0.05). At late follow-up, 191 of 259 patients (73.7%) were in stable sinus rhythm. Sinus rhythm was present in 64 patients (66.0%) in endocardial group while 127 patients (78.4%) in endocardial and epicardial group (P<0.05). Histopathology of the endocardial group revealed foci coagulative necrosis was limited to the endocardial side. While endocardial and epicardial ablation had full-thickness alteration of atrial tissue besides ill defined borders and inflammatory cell infiltration.

CONCLUSIONS

Combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure was performed safely and efficiently. And it restored sinus rhythm better than endocardial ablation only.

Links

Publisher Full Text

Authors+Show Affiliations

Wang JG
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. wangjiangang7545@126.com
Meng X
No affiliation info available
Li H
No affiliation info available
Cui YQ
No affiliation info available
Hou XT
No affiliation info available
Gao F
No affiliation info available
Zheng SH
No affiliation info available
Xu CL
No affiliation info available

MeSH

AdultAgedAtrial FibrillationCatheter AblationEndocardiumFemaleFollow-Up StudiesHumansMaleMiddle AgedPericardiumRetrospective StudiesTreatment Outcome

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

17537331

Citation

Wang, Jian-gang, et al. "[Combined Endocardial and Epicardial Radiofrequency Modified Maze Procedure in the Treatment of Atrial Fibrillation]." Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], vol. 45, no. 6, 2007, pp. 415-8.
Wang JG, Meng X, Li H, et al. [Combined endocardial and epicardial radiofrequency modified Maze procedure in the treatment of atrial fibrillation]. Zhonghua Wai Ke Za Zhi. 2007;45(6):415-8.
Wang, J. G., Meng, X., Li, H., Cui, Y. Q., Hou, X. T., Gao, F., Zheng, S. H., & Xu, C. L. (2007). [Combined endocardial and epicardial radiofrequency modified Maze procedure in the treatment of atrial fibrillation]. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], 45(6), 415-8.
Wang JG, et al. [Combined Endocardial and Epicardial Radiofrequency Modified Maze Procedure in the Treatment of Atrial Fibrillation]. Zhonghua Wai Ke Za Zhi. 2007 Mar 15;45(6):415-8. PubMed PMID: 17537331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Combined endocardial and epicardial radiofrequency modified Maze procedure in the treatment of atrial fibrillation]. AU - Wang,Jian-gang, AU - Meng,Xu, AU - Li,Hui, AU - Cui,Yong-qiang, AU - Hou,Xiao-tong, AU - Gao,Feng, AU - Zheng,Si-hong, AU - Xu,Chun-lei, PY - 2007/6/1/pubmed PY - 2008/8/19/medline PY - 2007/6/1/entrez SP - 415 EP - 8 JF - Zhonghua wai ke za zhi [Chinese journal of surgery] JO - Zhonghua Wai Ke Za Zhi VL - 45 IS - 6 N2 - OBJECTIVE: To evaluate the effectiveness of the combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure for the treatment of atrial fibrillation (AF). METHODS: During a period of 3 years, 295 patients with AF having concomitant cardiac surgery underwent the procedure. Patients underwent either the endocardial and epicardial group (n=185) or the endocardial group (n=110) radiofrequency ablation. There were 124 males, 171 females with a mean age of (52 +/- 11) year old. Mean duration of preoperative AF was 36 +/- 43 months. And about 90.8 percent valve pathology was rheumatic. Valve operation was performed in 289 patients, coronary artery bypass graft surgery in 19 patients and congenital heart disease operation in 6 patients respectively. Follow-up for the whole patients ranged from 3 to 47 months (mean 28 +/- 5 months). RESULTS: Ten patients died postoperatively (3.4%). Four patients died of low cardiac output, five patients died of multisystem and organ failure, one patient died of cerebral hernia. There were 2 patients died of nerves system complication during follow-up. At the end of the procedure 228 patients (77.3%) were sinus rhythm, including 78 patients (70.9%) in endocardial group while 150 patients (81.1%) in endocardial and epicardial group (P<0.05). At late follow-up, 191 of 259 patients (73.7%) were in stable sinus rhythm. Sinus rhythm was present in 64 patients (66.0%) in endocardial group while 127 patients (78.4%) in endocardial and epicardial group (P<0.05). Histopathology of the endocardial group revealed foci coagulative necrosis was limited to the endocardial side. While endocardial and epicardial ablation had full-thickness alteration of atrial tissue besides ill defined borders and inflammatory cell infiltration. CONCLUSIONS: Combined endocardial and epicardial saline-irrigated radiofrequency modified maze procedure was performed safely and efficiently. And it restored sinus rhythm better than endocardial ablation only. SN - 0529-5815 UR - https://www.unboundmedicine.com/medline/citation/17537331/[Combined_endocardial_and_epicardial_radiofrequency_modified_Maze_procedure_in_the_treatment_of_atrial_fibrillation]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0529-5815&amp;year=2007&amp;vol=45&amp;issue=6&amp;fpage=415 DB - PRIME DP - Unbound Medicine ER -