Abstract 10678: How Well Does Patient Self Report of Rhythm Following the Cox-Maze Procedure Fair When Tested Against Long Term Monitoring at 6 Months?
Objective: The true success of the Cox-Maze procedure may be difficult to determine when depending solely on patient self report or ECG. The purpose of this study was to determine if patient self report is a reliable measure to determine rhythm following the Cox Maze III (CMIII) procedure when compared to their rhythm captured with 1 week long term monitoring (LTM).
Methods: Prospective longitudinal follow up through clinical surveys and by a set protocol at 3,6,9,12,18, 24 months and yearly thereafter. All patients were requested to undergo a week long holter monitor at 6 months post CMIII procedure.
Results: One hundred and sixty one patients have completed a week long monitoring and returned their respective surveys. Throughout the study patients' self report correlated well with EKG analysis. In the early years of our program (2004-2006), 19% of the patient self report of rhythm was incorrect when compared to the results of the LTM. The majority (67%) of these patients reported SR when in fact they were having episodes of atrial arrhythmias > 30 seconds. In the more recent years of our program (2007-2010), only 8% (significant difference p=0.06) of patient self report was incorrect with the majority of these patients reporting SR when in fact they experienced atrial arrhythmias > 30 seconds. Patient's number of office visits with their cardiologists during the first 6 months increased from 2 (1.1) to an average of 3 (1) when comparing the different study periods(p<0.010).
Conclusion: Patient self report of rhythm following surgical ablation correlated well with EKG but not as well with LTM. However, patient perception can be improved through closer monitoring at office visits and education. Long term monitoring is a very important clinical tool especially with regard to the management of anticoagulation and the reporting of the results of surgical ablation.
- © 2011 by American Heart Association, Inc.