• BACKGROUND: Cox Maze surgery for atrial fibrillation (AF) has been found to have high efficacy in maintaining sinus rhythm and has been shown to improve quality of life early after surgery, but reports on long-term effects in this respect are lacking. This study was therefore undertaken to evaluate the effect of the Maze procedure on health-related quality of life in the long term. METHODS: Patients with drug-refractory AF undergoing the 'cut and sew' Maze III procedure without any modification were assessed with the SF-36 Health Survey regarding quality of life at baseline and late after surgery. Totally 61 patients, mean age 55 years (range: 29-74 years), were evaluated. At the time of surgery, 34 patients (56%) had paroxysmal or persistent AF and the remainder had permanent AF. RESULTS: At late follow-up, at a mean of 55+/-12 months, 54 patients (89%) were free from AF recurrences and another five patients (8%) had experienced only one or a few AF episodes. All eight scales on the SF-36 Health Survey were significantly improved at long-term follow-up compared to baseline. The quality-of-life improvement was seen both in patients with paroxysmal/persistent AF and in those with permanent AF. At long-term follow-up, the quality-of-life scores were comparable with those of the general population. CONCLUSIONS: The Cox Maze III procedure has good long-term efficacy for rhythm control in patients with medically refractory AF, resulting in a quality-of-life improvement, which is maintained late after surgery.

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