Abstract 14292: A New MAZE Procedure With Intensive Pulmonary Veins Isolation
Objective: Combined treatment of pulmonary vein isolation (PVI) and ganglionated plexus (GP) ablation has been developed as a treatment of atrial fibrillation (AF). We investigated the effect of new MAZE procedure with intensive PVI guided by GP mapping on postoperative maintenance of sinus rhythm in patients with chronic AF, and compared with that in patients undergoing the MAZE procedure with conventional PVI.
Methods: We studied 43 patients [conventional PVI group: 68.8±5.7 years] and 24 patients [intensive PVI group: 66.9±7.4 (SD) years] who underwent the MAZE procedure for chronic AF. The MAZE procedure was conducted by the endocardial application of bipolar radiofrequency (RF) ablation. Lesion sets in the left atrium were similar in the 2 groups. In the conventional PVI group, PVI was applied 3 times for the entrance of 4 pulmonary veins. In the intensive PVI group, PVI was further repeated several times for the bilateral GP regions identified by a rapid atrial pacing test.
Results: The MAZE procedure was successfully completed in all 67 patients without complications. The duration of chronic AF, the prevalence of concomitant mitral valvular disease and the postoperative follow-up period were comparable between the 2 groups. At 20.8±9.0 months after the surgery, sinus rhythm was maintained in 25 (53%) of 43 patients of the conventional PVI group. In contrast, it was maintained in 20 (83%) of 24 patients of the intensive PVI group (p<0.05).
Conclusions: New MAZE procedure with intensive PVI guided by GP mapping largely contributes to the long-term maintenance of sinus rhythm.
- © 2010 by American Heart Association, Inc.