Long-Term Results Following Concomitant Radiofrequency Modified Maze Ablation for Atrial Fibrillation

Background and aim of study: This study evaluated the long-term outcome of linear, endocardial, radiofrequency (RF) atrial ablation for the treatment of atrial fibrillation (AF) concomitantly to open-heart procedures for acquired cardiac organic disease. Methods: A saline-irrigated “pen-like” RF ablation catheter (Cardioblate®, Medtronic, Minneapolis, MN, USA) was used to perform endocardial lines of conduction block in 293 patients with AF who underwent open-heart procedures between September 2000 and February 2008. Results: Patients (age of 65 ± 11 years) underwent left atrial ablation for permanent (44%), paroxysmal (51%), or undetermined (4.4%) AF. Maintenance in sinus rhythm (SR) at discharge and at the end of follow-up (average 3.3 ± 1.2 years) was observed in 52% and 71% of patients, respectively. Preoperative type or duration of AF did not influence the results (p = NS). Multivariate analysis with a logistic regression model showed left atrial diameter and increasing age were independent predictors of recurrent AF. In this study, return to SR did not influence survival. Conclusions: This study confirmed that concomitant intraoperative RF ablation is an effective technique to restore long-term SR after cardiac surgery in patients with preoperative AF but does not influence long-term survival. (J Card Surg 2010;25:608-613)