A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation

Ad, Niv; Holmes, Sari D.; Ali, Rabia; Pritchard, Graciela; Lamont, Deborah

doi:10.1016/j.jtcvs.2016.12.047

Cited by 23 publications

(18 citation statements)

References 31 publications

(50 reference statements)

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“…Every lesion of the two procedures were exactly the same so, clearly, the elimination of the extensive extracardiac dissection also contributed to the decreased requirements for postoperative pacemakers. This observation has now been confirmed at a single center in more than 700 patients undergoing the cryosurgical maze-III procedure in which only 7% of patients required new pacemakers postoperatively [40].…”

Section: Unmasking Preoperative Sick Sinus Syndromementioning

confidence: 74%

The Maze Procedure and Postoperative Pacemakers

Cox

Churyla

et al. 2018

The Annals of Thoracic Surgery

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Section: Unmasking Preoperative Sick Sinus Syndromementioning

confidence: 74%

The Maze Procedure and Postoperative Pacemakers

Cox

Churyla

et al. 2018

The Annals of Thoracic Surgery

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“…According to the literature, the incidence of PPM insertion after the maze procedure is 7%–11% [ 2 , 5 ]. In this study, the incidence of PPM insertion was 5.7% in group A and 2.0% in group B; these rates are consistent with those reported in previous studies [ 2 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Performing a maze procedure for the treatment of AF concomitantly with other cardiac procedures can prolong the operation time, cardiopulmonary bypass (CPB) time, and cardiac arrest time. In addition, surgical ablation increases the risk of postoperative bleeding and the need for permanent pacemaker (PPM) insertion [ 2 , 3 ]. However, the substantial benefits from regaining sinus rhythm and atrial contractility warrant the potential risks [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

Kim

Chung

Kim

et al. 2018

Korean J Thorac Cardiovasc Surg

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BackgroundLimited comparative data are available on the efficacy of cryoablation versus radiofrequency ablation in patients with atrial fibrillation. This study aimed to compare radiofrequency ablation and cryoablation with regard to clinical outcomes and the restoration of sinus rhythm or atrial contractility.MethodsA total of 239 patients who underwent surgical ablation between August 2003 and December 2016 at our institution were included. The patients were divided into 2 groups according to the energy device that was used (group A: n=140, radiofrequency ablator; group B: n=99, cryoablator). Echocardiographic data, overall survival, and major cardiovascular and cerebrovascular event (MACCE)-free survival were compared between the 2 groups.ResultsAt 1 year of follow-up, the atrial contractility recovery rate was 32.2% (19 of 59) in group A and 48.8% (21 of 44) in group B. In addition, cryoablation was found to be a predictive factor for the recovery of atrial contractility (cryoablation vs. radiofrequency ablation: odds ratio, 2.540; 95% confidence interval, 1.063–6.071; p=0.036). The left ventricular ejection fraction was significantly higher in group B (53.1%±11.5% vs. 59.1%±6.3%, p=0.001). The median follow-up duration was 36 months. The 5-year overall survival rate was 80.1%±3.6% in group A and 92.1%±2.9% in group B (p=0.400). The 5-year MACCE-free survival rate was 70.3%±4.0% in group A and 70.9%±5.6% in group B (p=0.818).ConclusionCryoablation was associated with a higher atrial contractility restoration rate and better left ventricular function than radiofrequency ablation. However, no significant relationship was observed between the energy source and overall or MACCE-free survival.

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“…86 Furthermore, Ad et al have demonstrated that the most common subgroup of patients undergoing the Cox-maze IV to require PPM implantation are those undergoing 2 or more concomitant valve procedures; however, implantation rates remained low at 14% in their series and were not associated with increased morbidity, rhythm failure, or reduction in long-term survival. 87 Exclusion of the right atrial lesion set has been explored to further reduce the PPM implantation rates. Statistically significant reductions in PPM implantation rates were demonstrated in these circumstances with PPM rates as low as 5.4% in the left atrial lesion set only group.…”

Section: Heart Block and Pacemaker Implantationmentioning

confidence: 99%

Treatment Complications of Atrial Fibrillation and Their Management

2020

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Atrial fibrillation (AF) is a rhythm disturbance defined by irregular, rapid electrical, and mechanical activation of the atria, which causes unsynchronized atrial contraction and promotes thromboembolism. AF is the most common sustained arrhythmia. Its prevalence and incidence are increasing due to aging and improved survival from acute heart diseases. This article is a review on AF management from both a surgical and catheter-based perspective. While both treatment approaches to AF have been shown to be successful in the management of AF, they are not without their own inherent complications. This article seeks to review some of these complications and help to guide treatment.

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A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation

Cited by 23 publications

References 31 publications

The Maze Procedure and Postoperative Pacemakers

The Maze Procedure and Postoperative Pacemakers

Comparison of Radiofrequency Ablation and Cryoablation for the Recovery of Atrial Contractility and Survival

Treatment Complications of Atrial Fibrillation and Their Management

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