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- Blomström-Lundqvist, Carina, et al.
(författare)
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A randomized double-blind study of epicardial left atrial cryoablation for permanent atrial fibrillation in patients undergoing mitral valve surgery: the SWEDish Multicentre Atrial Fibrillation study (SWEDMAF).
- 2007
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 28:23, s. 2902-8
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The efficacy of epicardial left atrial (LA) cryoablation in eliminating atrial fibrillation (AF) in patients undergoing mitral valve surgery (MVS) is unknown. We hypothesized that MVS combined with LA cryoablation is superior to MVS alone. METHODS AND RESULTS: Sixty-nine patients with permanent AF, included at four centres, underwent MVS with or without epicardial LA cryoablation. The primary endpoint was regained sinus rhythm. Risk factors for failed AF cryoablation were elucidated. Sixty-five out of 69 patients reached the primary endpoint. At 6 and 12 months follow-up, 73.3% of patients who underwent cryoablation had regained sinus rhythm at both follow-ups, compared with 45.7 and 42.9% of patients, respectively, who underwent MVS alone (group differences, at 6 months P = 0.024, after 12 months P = 0.013). The in-hospital complication rate was 11.4% in the MVS group and 26.5% in the cryoablation group (P = 0.110). Risk factors for failed elimination of AF by cryoablation were duration of permanent AF (P = 0.012) and presence of coronary artery disease (P = 0.047), according to multiple logistic regression analysis. CONCLUSION: This first prospective randomized study showed that combining MVS with epicardial LA cryoablation is significantly better in eliminating pre-operative permanent AF than MVS alone.
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| 2. |
- Wierup, Per, et al.
(författare)
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Health care consumption due to atrial fibrillation is markedly reduced by Maze III surgery.
- 2007
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Ingår i: The Annals of thoracic surgery. - : Elsevier BV. - 1552-6259 .- 0003-4975. ; 83:5, s. 1713-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Health care consumption and costs for the treatment of atrial fibrillation are high. Atrial fibrillation is effectively treated by the surgical Maze III procedure according to the Cox method. We describe the effects of this procedure on health care consumption and economy. METHODS: From October 1997 through March 2002, 72 patients underwent the Maze III procedure. Medical records of these patients were reviewed, and all data regarding hospitalization and outpatient clinic visits for atrial fibrillation and its related diseases were recorded. Accounting divisions from the contributing hospitals were consulted for the exact cost of each of these services, which were allocated into preoperative, perioperative, and postoperative periods. RESULTS: The perioperative mortality was zero. Long-term freedom from symptomatic atrial fibrillation was verified in 96% of the patients. The number of hospitalization days decreased by 84%, from 471 during the preoperative period to 79 in the postoperative (p < 0.001), and costs during the same periods decreased by 75%, from 7,075,000 Swedish Kronor to 1,757,000 Swedish Kronor (p < 0.001). CONCLUSIONS: The Maze III procedure significantly decreased the postoperative hospitalization costs in patients undergoing surgery primarily for atrial fibrillation. As well as providing an effective treatment for symptomatic arrhythmia, this procedure breaks the undesirable trend of increasing health care consumption resulting from treatment of atrial fibrillation.
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