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

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

Article Type

Original Study

Subject Area

Cardiothoracic Surgery

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.

IRB Number

IHC00079

Keywords

Atrial fibrillation; radiofrequency ablation; Maze procedure.

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