The effect of ablation technology on surgical outcomes after the Cox-maze procedure: A propensity analysis

Abstract

The use of bipolar radiofrequency ablation has simplified the Cox-maze procedure, making it applicable to virtually all patients with atrial fibrillation undergoing concomitant cardiac surgery. The Cox-maze IV procedure produces similar surgical outcomes to the Cox-maze III procedure at 1 year of follow-up.

Surgical Ablation for Atrial Fibrillation

“…Propensity score matching comparing the two procedures showed similar rates of freedom from AF at 1 year (Table 1). 16 Interestingly, the study did not report any decrease in morbidity with CM-IV compared to CM-III (Figure 2).…”

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

“…A propensity analysis, matching patients who underwent an ablation-assisted Cox-Maze with those having had a traditional cut-and-sew Cox-Maze III, showed no differences in freedom from AF at 3, 6, and 12 months of follow-up. 1307 Further recent work has shown significantly improved results when the entire posterior LA is excluded by the so-called box lesion. 1306,1308 …”

Fontan conversion with novel direct ablation after childbirth: Report of a case

“…The method used to create lesions differs greatly in the cut-and-sew and ablation procedures, 18 and an incision always creates a conduction block across the suture line. However, although the bipolar RF ablation device allows the surgeon to isolate targeted tissue and create transmural lesions, [14][15][16][17] it is not absolutely perfect because all the lesions produced a clinical conduction block.…”