Left versus bi-atrial intraoperative saline-irrigated radiofrequency modified maze procedure for atrial fibrillation.

Cardiac electrophysiology review · 2003 · Unclear · Low evidence

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UnclearLow evidencePaper 3739

Study snapshot

PublicationCardiac electrophysiology review · 2003

Study typeother

Reported directionUnclear

Evidence ratingLow

Abstract

BACKGROUND: This study was conducted to evaluate the effectiveness of the saline-irrigated radiofrequency modified maze operation for the treatment of chronic atrial fibrillation (AF) and compare the results of the left and bi-atrial procedures. MATERIAL AND METHOD: During a period of two years, 105 patients with chronic AF having concomitant cardiac surgery underwent the procedure. Patients underwent either a bi-atrial ( n = 48) or left atrial ( n = 57) maze procedure. The first twenty patients underwent a bi-atrial maze procedure regardless of the pathology. In the following patients we adopted the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side. Mean age was 52 +/- 11 years in bi-atrial group and 54 +/- 9 years in left atrial group. RESULTS: Three patients died early postoperatively (2.9%). There were 4 revisions for bleeding (3.8%). Two patients in bi-atrial group received a permanent pacemaker (4.1%). Patients in both groups were free of AF at the end of the procedure. (Bi-atrial group: sinus: 79.2%, pacemaker: 20.8%), (Left atrial group: sinus: 82.5%, pacemaker: 17.5%) ( p > 0.05). During the last follow-up, sinus rhythm was maintained in 79.6% of cases in bi-atrial group, while this rate was 75.6% in left atrial group ( p > 0.05). CONCLUSION: Saline irrigated radiofrequency modified maze procedure was performed safely and efficiently. Both the left and bi-atrial procedures were successful in terms of restoring sinus rhythm. Our current policy is to adopt the bi-atrial approach in patients with a history of atrial flutter and where the right atrium has to be opened. Otherwise the procedure is restricted to the left atrial side.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typeother

Effect directionunclear

PopulationPatients with chronic atrial fibrillation undergoing concomitant cardiac surgery

Sample size105

ExposureNot supplied

Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

In 105 patients undergoing saline-irrigated radiofrequency modified maze during concomitant cardiac surgery, both bi-atrial (n=48) and left atrial (n=57) procedures resulted in patients being free of AF at the end of the procedure, with no significant between-group differences. At last follow-up, sinus rhythm was maintained in 79.6% (bi-atrial) vs 75.6% (left atrial) (p>0.05). Early postoperative mortality was 2.9%, bleeding revisions 3.8%, and 4.1% of bi-atrial patients received a permanent pacemaker.

Outcomes measured

Freedom from atrial fibrillation / restoration of sinus rhythm
Postoperative mortality
Revisions for bleeding
Permanent pacemaker implantation

Limitations

Non-randomized group assignment (first 20 patients received bi-atrial regardless of pathology; later selection based on clinical factors)
Follow-up duration not specified in abstract
Details of follow-up methods and AF ascertainment not provided
No radiofrequency exposure parameters (e.g., frequency, power, lesion set specifics) reported

View raw extracted JSON

{
  "study_type": "other",
  "exposure": {
    "band": null,
    "source": "intraoperative saline-irrigated radiofrequency (surgical ablation)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Patients with chronic atrial fibrillation undergoing concomitant cardiac surgery",
  "sample_size": 105,
  "outcomes": [
    "Freedom from atrial fibrillation / restoration of sinus rhythm",
    "Postoperative mortality",
    "Revisions for bleeding",
    "Permanent pacemaker implantation"
  ],
  "main_findings": "In 105 patients undergoing saline-irrigated radiofrequency modified maze during concomitant cardiac surgery, both bi-atrial (n=48) and left atrial (n=57) procedures resulted in patients being free of AF at the end of the procedure, with no significant between-group differences. At last follow-up, sinus rhythm was maintained in 79.6% (bi-atrial) vs 75.6% (left atrial) (p>0.05). Early postoperative mortality was 2.9%, bleeding revisions 3.8%, and 4.1% of bi-atrial patients received a permanent pacemaker.",
  "effect_direction": "unclear",
  "limitations": [
    "Non-randomized group assignment (first 20 patients received bi-atrial regardless of pathology; later selection based on clinical factors)",
    "Follow-up duration not specified in abstract",
    "Details of follow-up methods and AF ascertainment not provided",
    "No radiofrequency exposure parameters (e.g., frequency, power, lesion set specifics) reported"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "atrial fibrillation",
    "maze procedure",
    "radiofrequency ablation",
    "saline-irrigated",
    "bi-atrial",
    "left atrial",
    "cardiac surgery",
    "sinus rhythm"
  ],
  "suggested_hubs": []
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1023/b:cepr.0000012393.09666.26
PubMed: 14739724

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