Copyright © 2002 by the European Society of Cardiology.
Efficacy of an additional MAZE procedure using cooled-tip radiofrequency ablation in patients with chronic atrial fibrillation and mitral valve disease. A randomized, prospective trial
a Department of Cardiology, University Hospital Bergmannsheil, Bochum, Germany
b Clinic for Cardiothoracic Surgery, University Hospital Bergmannsheil, Bochum, Germany
c Institute of Pathology, University Hospital Bergmannsheil, Bochum, Germany
revised June 15, 2001; accepted June 27, 2001
Abstract
Aims This study is the first prospective randomized trial evaluating the efficacy of an antiarrhythmic surgical procedure in patients with chronic atrial fibrillation undergoing mitral valve replacement.
Methods and Results Thirty consecutive patients with chronic atrial fibrillation undergoing mitral valve replacement were randomized for an additional modified MAZE-operation using intra-operatively cooled-tip radiofrequency ablation (group A) or mitral valve replacement alone (group B). Biatrial contraction was studied and functional capacity was evaluated in spiro-ergometry 6 months after surgery. Thirty-day mortality was 0% in both groups. After 12 months, sinus rhythm was reinstituted significantly more often in patients of group A (cumulative rate of sinus rhythm 0·800) compared to patients in group B (0·267) (P<0·01). 66·7% of patients in sinus rhythm of group A had documented biatrial contraction. Electrocardioversion showed long-term success in only 17% of patients in group A and 0% in group B. Maximal aerobic uptake at the 6-month spiro-ergometry revealed no significant difference (9·3 vs 8·5ml.min–1 kg–1, P=0·530).
Conclusions A modified MAZE operation using cooled-tip radiofrequency ablation can be safely combined with mitral valve surgery and is highly effective in restoring sinus rhythm. Biatrial contraction is found in 66·7% of patients with sinus rhythm undergoing mitral valve replacement plus the MAZE operation.
Key Words: MAZE surgery, cooled-tip radiofrequency ablation, sinus rhythm, atrial fibrillation, biatrial contraction, functional results
f1 Correspondence: Thomas Deneke, Department of Cardiology, Bergmannsheil Bochum, University of Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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