Long-Term Follow-Up of Cardiac Rhythm in 320 Patients After the Cox-Maze III Procedure for Atrial Fibrillation

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Albåge, AndersUppsala universitet,Thoraxkirurgi (författare)

Long-Term Follow-Up of Cardiac Rhythm in 320 Patients After the Cox-Maze III Procedure for Atrial Fibrillation

Artikel/kapitelEngelska2016

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Elsevier BV,2016
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LIBRIS-ID:oai:DiVA.org:uu-294681
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-294681URI
https://doi.org/10.1016/j.athoracsur.2015.09.066DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:133286365URI

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Språk:engelska
Sammanfattning på:engelska

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Background. The Cox-maze III (CM-III) procedure is the gold standard for surgical treatment of atrial fibrillation (AF). Excellent short-term results have been reported, but long-term outcomes are lesser known. The aim was to evaluate current cardiac rhythm in a nationwide cohort of CM-III patients with very long follow-up.Methods. Perioperative characteristics were retrospectively analyzed in 536 "cut-and-sew" CM-III patients operated on from 1994 to 2009 in 4 centers. Of these, 54 patients had died and 20 were unavailable at follow-up. The remaining 462 patients received a survey concerning arrhythmia symptoms, rhythm, and medication; of these, 320 patients (69%), comprising 252 men, with a mean age of 67 years (range, 47 to 87 years), and 83% with stand-alone CM-III, returned a current 12-lead electrocardiogram. Long-term monitoring was evaluated in 40 sinus rhythm patients. Postoperative stroke/transient ischemic attack was evaluated by register analysis.Results. Mean follow-up was 111 44 months (range, 36-223 months). Electrocardiogram analysis showed sinus rhythm in 219 of 320 patients (68%), and regular supraventricular rhythm (sinus, nodal, or atrial pacing) in 262 (82%), with 75% off class I/III antiarrhythmic medication. This group had lower arrhythmia symptom scores and medication use. Rhythm outcome did not differ by gender, age, type of AF, or stand-alone vs concomitant operation. Patients with more than 10 years of follow-up had a lower rate of regular supraventricular rhythm (69% vs 91%, p = 0.02). Long-term monitoring showed freedom from AF/atrial flutter in 38 of 40 patients (95%). The incidence of stroke/transient ischemic attack was 0.37% per year (11 patients).Conclusions. In a single-moment electrocardiogram evaluation 9 years after the cut-and-sew CM-III, 82% of patients were in sinus rhythm or other regular supraventricular rhythm. These findings support a long-lasting positive effect of the CM-III procedure, which is relevant when evaluating current nonpharmacologic therapies for AF. (C) 2016 by The Society of Thoracic Surgeons

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Johansson, BirgittaDepartment of Internal Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden (författare)
Kenneback, GoranKarolinska Institutet (författare)
Källner, GöranKarolinska Institutet (författare)
Schersten, HenrikDepartment of Cardiovascular Surgery, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden (författare)
Jideus, LenaUppsala universitet,Thoraxkirurgi(Swepub:uu)lenajide (författare)
Uppsala universitetThoraxkirurgi (creator_code:org_t)

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Ingår i:Annals of Thoracic Surgery: Elsevier BV101:4, s. 1443-14490003-49751552-6259

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Av författaren/redakt...: Albåge, Anders; Johansson, Birgi ...; Kenneback, Goran; Källner, Göran; Schersten, Henri ...; Jideus, Lena

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin

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Av lärosätet: Uppsala universitet; Karolinska Institutet

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