Surgical Radiofrequency Ablation Using the Left Modified Maze Procedure in the Treatment of Chronic Atrial Fibrillation during Mitral Valve Surgery – Early Results

Authors

Ahmed A Faragalla, National Heart Institute, Cardiac Surgery DeptFollow
Ahmed M Elshiemy, National Heart Institute, Cardiac Surgery Dept
Sherif A Elhendawy, National Heart Institute, Cardiac Surgery Dept
Ahmed A. Abdelhamid, National Heart Institute, Cairo, Egypt

Abstract

ABSTRACT Background: Complex Cox-Maze III is standard for atrial fibrillation in mitral valve surgery. Radiofrequency ablation, a newer energy-based method, might be simpler and less risky. Aim of the work: Assessing the Efficacy of Surgical Radiofrequency Ablation for Chronic Atrial Fibrillation with Left Atrial Modified Maze Procedure in Mitral Valve Surgery. Patients and Methods: A randomised controlled study (80 patients, mitral valve disease + chronic atrial fibrillation) compares a left-modified Maze with radiofrequency ablation (Group A/40) vs. mitral valve surgery alone (Group B/40) at the National Heart Institute—primary outcome: Restoration of sinus rhythm. Results: This randomized controlled study (n=80, mitral valve disease + chronic AF) found similar baseline characteristics between Maze with radiofrequency ablation (Group A) and control (Group B). Group A achieved significantly greater sinus rhythm rates at all follow-ups (e.g., 67.5% vs 17.5% at 6 months). Both groups experienced reduced left atrial volume, with a more pronounced decrease in patients achieving sinus rhythm. Preoperative left atrial size and atrial fibrillation duration predicted the successful restoration of sinus rhythm. Conclusion: This study suggests unipolar left atrial radiofrequency ablation during MVS (mitral valve surgery) for chronic atrial fibrillation is safe and effective (67.5% sinus rhythm at 6 months). Preoperative left atrial size and atrial fibrillation duration predicts success. Further long-term data is needed. Keywords: Atrial fibrillation; radiofrequency ablation; Maze procedure. Key message: Unipolar left atrial ablation during mitral valve surgery is safe and effective for chronic atrial fibrillation, improving sinus rhythm rates.

Article Type

Original Study

Subject Area

Cardiothoracic Surgery

IRB Number

IHC00079

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Recommended Citation

Faragalla, Ahmed A; Elshiemy, Ahmed M; Elhendawy, Sherif A; and Abdelhamid, Ahmed A. (2024) "Surgical Radiofrequency Ablation Using the Left Modified Maze Procedure in the Treatment of Chronic Atrial Fibrillation during Mitral Valve Surgery – Early Results," Journal of Medicine in Scientific Research: Vol. 8: Iss. 2, Article 4.
DOI: https://doi.org/10.59299/2537-0928.1430