Catheter ablation for failed surgical maze: comparison of cut and sew vs. non-cut and sew maze

Purpose To compare findings in patients undergoing atrial fibrillation(AF) and/or atrial flutter(AFl) ablation after failed cut and sew (CS) vs. non-cut and sew (NCS) surgical maze. Methods We compared 10 patients with prior CS to 25 with prior NCS maze undergoing catheter ablation after failed maze...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2019-08, Vol.55 (2), p.183-189
Main Authors: Winkle, Roger A., Fleming, William, Mead, R. Hardwin, Engel, Gregory, Kong, Melissa H., Salcedo, Jonathan, Patrawala, Rob A., Castro, Luis, Gaudiani, Vincent
Format: Article
Language:English
Subjects:
Ablation
Aged
Arrhythmia
Atrial Fibrillation - surgery
Atrial Flutter - surgery
Cardiac arrhythmia
Cardiac Surgical Procedures - methods
Cardiology
Catheter Ablation - methods
Catheters
Demographics
Demography
Electrocardiography
Epicardial Mapping
Female
Fibrillation
Flutter
Heart surgery
Humans
Male
Medical instruments
Medicine
Medicine & Public Health
Patients
Pulmonary Veins - surgery
Radio frequency
Radiofrequency ablation
Recurrence
Reoperation
Retrospective Studies
Surgery
Tachycardia
Ultrasound
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Summary:Purpose To compare findings in patients undergoing atrial fibrillation(AF) and/or atrial flutter(AFl) ablation after failed cut and sew (CS) vs. non-cut and sew (NCS) surgical maze. Methods We compared 10 patients with prior CS to 25 with prior NCS maze undergoing catheter ablation after failed maze. Results Patient demographics: Age 68.3 ± 8.7 CS vs. 68.2 ± 9.2 NCS( P  = 0.977), male 70% CS vs. 72% NCS( P  = 1.000), LA size 5.11 ± 0.60 cm CS vs. 4.54 ± 0.92 cm NCS( P  = 0.096), sternotomy 100% CS vs. 64% of NCS( P  = 0.036). Concomitant heart surgery in 100% CS and 68% NCS( P  = 0.073). NCS used radiofrequency 84%, cryoablation 8%, microwave 4%, and ultrasound 4%. All maze operations targeted pulmonary vein (PV) isolation. The maze also targeted the mitral isthmus 100% CS vs. 36% NCS( P  = 0.001) and the tricuspid isthmus 90% CS vs. 40% NCS ( P  = 0.018). Maze failure arrhythmia mechanism was AF 0% CS and 56% NCS ( P  = 0.0006). Nine CS pts failed for AFl and 1 for RA tachycardia. For NCS pts, 11 failed for AFl. CS isolated 94% of PVs and NCS isolated only 26% of PVs ( P  
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-019-00509-y