Predictors of Sinus Rhythm Restoration after Maze Operation and Relationship between Pre- and Post-operative Left Atrial Volume

Kim, Yong Hoon; Lee, Sang‐Chol; Oh, Hye Lim; Rhee, Il; Lee, Sang Hoon; Hong, Kyung Pyo; Park, Pyo Won; Park, Jeong Euy; Seo, Jung Don

doi:10.4070/kcj.2004.34.6.574

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…In agreement with previous studies, [21][22][23][24][25] we found that the preoperative LAVI was an important determinant of SR restoration after the maze procedure, whereas the immediate postoperative LAVI was not associated with restoration of SR. Moreover, our study showed that preoperative LAEV and LAEF were not significantly different between the two groups.…”

Section: Discussionsupporting

confidence: 93%

Atrial Mechanical Function After Maze Procedure for Atrial Fibrillation Concomitant With Mitral Valve Surgery

et al. 2008

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Background and Objectives:The maze procedure is effective in restoring sinus rhythm (SR) in patients with atrial fibrillation (AF). We compared the left atrial mechanical function (LAMF) of patients whose rhythm was converted to SR after maze procedure with that of patients whose rhythm was not converted to SR and determined if preoperative left atrial volume index (LAVI) and immediate postoperative LAMF could predict conversion of AF to SR. Subjects and Methods: We prospectively evaluated 80 patients with AF treated with the maze procedure between March 2005 and February 2007. LAMF was assessed by looking at left atrial ejection volume (LAEV) and ejection fraction (LAEF) during echocardiography before, 2 weeks after, and 6 months after the procedure. Results: Of the 80 enrolled patients, 71 were converted to SR after the maze procedure (SR group), and 9 were not converted to SR (AF group). There were no significant differences in age, sex, hypertension, diabetes mellitus, renal failure, stroke, thyroid dysfunction, or smoking history between the groups. Pre-operative LAVI (p=0.010) was a predictor of conversion of AF to SR. LAEF gradually increased in the SR group during follow-up, but not in the AF group.

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Section: Discussionsupporting

confidence: 93%

Atrial Mechanical Function After Maze Procedure for Atrial Fibrillation Concomitant With Mitral Valve Surgery

et al. 2008

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“…Many studies have examined LA systolic function using a variety of parameters, such as LA emptying volume and LA emptying volume fraction, 13) 14) LA fractional shortening or fractional area change, 15) Doppler transmitral flow parameters (peak A wave velocity and its time-velocity integral, or E/A ratio, 16) LA work load, 17) LA appendage flow velocities, 18) atrial ejection fraction, 19) and LA kinetic energy 20) ) and by tissue Doppler imaging of the mitral annulus during atrial systole. 21) However, some of these measurements require invasive procedures, 17) 20) whereas other measurements are highly sensitive to changes in cardiac loading conditions, LV systolic function, and autonomic state.…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic Assessments of Left Atrial Strain and Volume in Healthy Patients and Patients With Mitral Valvular Heart Disease by Tissue Doppler Imaging and 3-Dimensional Echocardiography

Shin

Kim

et al. 2009

Korean Circ J

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Background and ObjectivesThe purpose of the current study was to assess left atrial (LA) physiology in relation to associations between LA volume change and regional tissue velocities and strains, and to extend this information to patients with mitral stenosis (MS) or mitral regurgitation (MR).Subjects and MethodsTwenty-two healthy persons, 22 patients with moderate-to-severe MS, and 22 patients with moderate-to-severe MR were studied. Tissue velocities, strains, and time-volume curves of the LA were acquired using tissue Doppler imaging and 3-dimensional echocardiography.ResultsIn healthy controls, the maximal LA volume was negatively correlated with the posterior wall longitudinal systolic strain (r=-0.45, p=0.03). The time-to-maximal LA volume was positively correlated with the time-to-posterior wall longitudinal peak strain (r=0.46, p=0.03) and the time-to-circumferential peak strain (r=0.59, p=0.004). The LA active emptying fraction (LAactEF) was positively correlated with the posterior wall longitudinal peak systolic and late diastolic tissue velocities. In patients with MS, the maximal LA volume was negatively correlated with the posterior wall radial peak systolic velocity and the longitudinal late diastolic velocity. In patients with MS, the LAactEF had an additional positive correlation with the anterior wall longitudinal and circumferential systolic velocities, whereas the patients with MR had an additional positive correlation between the LAactEF and the lateral wall longitudinal peak strain as compared with the healthy cantrols.ConclusionLA longitudinal and circumferential deformations are more related than radial deformation to determining LA volume and function. The LA of patients with MS revealed a greater pathologic physiology than those of patients with MR.

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Characteristics of P wave in Patients with Sinus Rhythm after Maze Operation

Park

Kim

et al. 2010

J Korean Med Sci

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Maze operation could alter P wave morphology in electrocardiogram (ECG), which might prevent exact diagnosis of the cardiac rhythm of patients. However, characteristics of P wave in patients with sinus rhythm after the operation have not been elucidated systematically. Consecutive patients who underwent the modified Cox Maze operation from January to December 2007 were enrolled. The standard 12-lead ECG and echocardiography were evaluated in patients who had sinus rhythm at 6 months after the operation. The average axis of P wave was 65±30 degrees. The average amplitude of P wave was less than 0.1 mV in all 12-leads, with highest amplitude in V1. The most common morphology of P wave was monophasic with positive polarity (49%), except aVR lead, which was different from those in patients with enlarged left atrium, characterized by large P-terminal force in the lead V1. There were no significant differences in P-wave characteristics and echocardiographic parameters between patients with LA activity (30.6%) versus without LA activity (69.4%) at 6 months after the operation. In conclusion, the morphology of P wave in patients after Maze operation shows loss of typical ECG pattern of P mitrale: P wave morphology is small in amplitude, monophasic and with positive polarity.

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Predictors of Sinus Rhythm Restoration after Maze Operation and Relationship between Pre- and Post-operative Left Atrial Volume

Cited by 3 publications

References 20 publications

Atrial Mechanical Function After Maze Procedure for Atrial Fibrillation Concomitant With Mitral Valve Surgery

Atrial Mechanical Function After Maze Procedure for Atrial Fibrillation Concomitant With Mitral Valve Surgery

Echocardiographic Assessments of Left Atrial Strain and Volume in Healthy Patients and Patients With Mitral Valvular Heart Disease by Tissue Doppler Imaging and 3-Dimensional Echocardiography

Characteristics of P wave in Patients with Sinus Rhythm after Maze Operation

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