Randomized study of surgery for patients with permanent atrial fibrillation as a result of mitral valve disease

Surgical ablation for treatment of atrial fibrillation in cardiac surgery: a cumulative meta-analysis of randomised controlled trials

“…Seven studies had >50 patients,19 22 – 24 27 28 44 while the remaining studies had less than 50 patients 18 20 21 25 26 29 30 33 34. Six studies used radiofrequency ablation,18 19 22 27 29 30 four studies used Cox–Maze CS,20 21 24 25 three studies used cryoablation,23 28 44 five studies reported patients undergoing pulmonary vein isolation,20 21 24 28 44 and two studies used microwave ablation 26 34. Results for coronary artery bypass grafting (CABG) were reported in eight studies,22 23 25 26 29 33 34 44 while valvular surgery was studied in all RCTs except Pokushalov et al 33…”

“…Sinus rhythm was the primary endpoint in 13 studies,18 21–30 34 44 while AF-free survival was the primary endpoint in three studies 25 26 33. Antiarrhythmic drugs (AAD) were indicated for patients with restored sinus rhythm (SR) from cardioversion in four studies,19 24 25 26 for postoperative AF or flutter in four studies,20 21 23 28 given to all patients prophylactically, and weaned off in four studies,19 24 25 26 and not used at all in two studies (table 2). 33 34…”

Modified Maze Procedure for Atrial Fibrillation as an Adjunct to Elective Cardiac Surgery: Predictors of Mid-Term Recurrence and Echocardiographic Follow-Up

“…Immediate and midterm maze success rates (62% and 63%, respectively), as well as overall survival rates and the incidence of major sequelae, were similar to those previously reported. 17 Regarding maze surgery, a question that was not fully answered concerns the possible preoperative identification of features that might discourage ablation because of their strong association with failure to terminate arrhythmia. Earlier studies have detected various such factors, including old age, larger left atrial diameter, a long preoperative history of arrhythmia, lower amplitude of F wave, rheumatic mitral valve disease, permanent AF, and maze-lesion sets.…”

“…[18][19][20][21][22] In our study, only arrhythmia duration longer than 36 months was confirmed as an adverse variable; other issues emerged unexpectedly, and their significant role was corroborated by multiple statistical tools that we also used to evaluate the intrinsic nature of the arrhythmia (that is, its chance of recurring several times). 17 First, we conf irmed the importance of discharge rhythm, as was pointed out by Lazopoulos and colleagues 15 ; the consequent clinical application consists in prompt cardioversion of every tachyarrhythmia.…”

Meta-analysis of clinical outcomes of maze-related surgical procedures for medically refractory atrial fibrillation

“…We identified four RCTs and six retrospective comparative studies that met minimum quality criteria [12][13][14][15][16][17][18][19][20][21]. Two other studies were excluded, one due to lack of reporting [22], the other because some patients may not have been medically refractory [23].…”