Shun-Ichiro Sakamoto1, Yosuke Ishii2, Toshiaki Otsuka3, Masataka Mitsuno4, Tomoki Shimokawa5, Tadashi Isomura6, Hitoshi Yaku7, Tatsuhiko Komiya8, Goro Matsumiya9, Takashi Nitta2. 1. Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. saka-165@nms.ac.jp. 2. Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. 3. Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan. 4. Department of Cardiovascular Surgery, Hyogo College of Medicine, Hyogo, Japan. 5. Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan. 6. Department of Cardiovascular Surgery, IMS Tokyo Katsushika General Hospital, Tokyo, Japan. 7. Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 8. Department of Cardiovascular Surgery, Kurashiki Central Hospital, Okayama, Japan. 9. Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Abstract
OBJECTIVE: The benefit of adding ganglionated plexi ablation to the maze procedure remains controversial. This study aims to compare the outcomes of the maze procedure with and without ganglionated plexi ablation. METHODS: This multicenter randomized study included 74 patients with atrial fibrillation associated with structural heart disease. Patients were randomly allocated to the ganglionated plexi ablation group (maze with ganglionated plexi ablation) or the maze group (maze without ganglionated plexi ablation). The lesion sets in the maze procedure were unified in all patients. High-frequency stimulation was applied to clearly identify and perform ganglionated plexi ablation. Patients were followed up for at least 6 months. The primary endpoint was a recurrence of atrial fibrillation. RESULTS: The intention-to-treat analysis included 69 patients (34 in the ganglionated plexi ablation group and 35 in the maze group). No surgical mortality was observed in either group. After a mean follow-up period of 16.3 ± 7.9 months, 86.8% of patients in the ganglionated plexi ablation group and 91.4% of those in the maze group did not experience atrial fibrillation recurrence. Kaplan-Meier atrial fibrillation-free curves showed no significant difference between the two groups (P = .685). Cox proportional hazards regression analysis indicated that left atrial dimension was the only risk factor for atrial fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval 1.017-1.024, P = .019). CONCLUSION: The addition of ganglionated plexi ablation to the maze procedure does not improve early outcome when treating atrial fibrillation associated with structural heart disease.
OBJECTIVE: The benefit of adding ganglionated plexi ablation to the maze procedure remains controversial. This study aims to compare the outcomes of the maze procedure with and without ganglionated plexi ablation. METHODS: This multicenter randomized study included 74 patients with atrial fibrillation associated with structural heart disease. Patients were randomly allocated to the ganglionated plexi ablation group (maze with ganglionated plexi ablation) or the maze group (maze without ganglionated plexi ablation). The lesion sets in the maze procedure were unified in all patients. High-frequency stimulation was applied to clearly identify and perform ganglionated plexi ablation. Patients were followed up for at least 6 months. The primary endpoint was a recurrence of atrial fibrillation. RESULTS: The intention-to-treat analysis included 69 patients (34 in the ganglionated plexi ablation group and 35 in the maze group). No surgical mortality was observed in either group. After a mean follow-up period of 16.3 ± 7.9 months, 86.8% of patients in the ganglionated plexi ablation group and 91.4% of those in the maze group did not experience atrial fibrillation recurrence. Kaplan-Meier atrial fibrillation-free curves showed no significant difference between the two groups (P = .685). Cox proportional hazards regression analysis indicated that left atrial dimension was the only risk factor for atrial fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval 1.017-1.024, P = .019). CONCLUSION: The addition of ganglionated plexi ablation to the maze procedure does not improve early outcome when treating atrial fibrillation associated with structural heart disease.
Authors: Chawannuch Ruaengsri; Matthew R Schill; Ali J Khiabani; Richard B Schuessler; Spencer J Melby; Ralph J Damiano Journal: Eur J Cardiothorac Surg Date: 2018-04-01 Impact factor: 4.191
Authors: Sandro Gelsomino; Pieter Lozekoot; Mark La Meir; Roberto Lorusso; Fabiana Lucà; Carlo Rostagno; Attilio Renzulli; Orlando Parise; Francesco Matteucci; Gian Franco Gensini; Harry J G M Crjins; Jos G Maessen Journal: Int J Cardiol Date: 2015-05-01 Impact factor: 4.164