Efficacy of the Maze Procedure for Atrial Fibrillation Associated with Atrial Septal Defect

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is a common complication in elderly patients with atrial septal defect (ASD). The purpose of this study was to examine the efficacy of the maze procedure in these patients. MATERIALS AND METHODS: Between February 2000 and May 2011, 46 patients underwent the maze procedure as a concomitant operation with ASD closure. Three patients who underwent a right-sided maze were excluded, and one patient was lost to follow-up. The mean follow-up duration was 3.2+/-2.5 years. Electrocardiography was performed 1 month, 3 months, 6 months, and 1 year after surgery, and checked annually after that. RESULTS: AF persisted in 4 patients after surgery. One year after surgery, among 38 patients, 55.3% remained in sinus rhythm without antiarrhythmic drugs. However, when including the patients who took antiarrhythmic drugs, 92.1% were in sinus rhythm. Freedom from AF recurrence at 3 months, 6 months, 1 year, 2 years, 3 years, and 5 years after surgery were 97.4+/-2.6, 94.4+/-3.8, 91.2+/-4.9, 87.8+/-5.8, 79.5+/-7.6, and 68.2+/-12.4, respectively. There was no early mortality after operation. CONCLUSION: Concomitant treatment with the maze procedure and ASD closure is safe and effective for restoring the sinus rhythm.