Surgical treatment of atrial fibrillation

Abstract

Recently, two new rationale for surgical treatment of atrial fibrillation have been developed which have been used, initially, primarily in patients with lone atrial fibrillation. We performed the 'corridor' operation in eleven patients with paroxysmal or chronic atrial fibrillation. Postoperatively, eight patients had normal sinus rhythm, one had a junctional rhythm, one patient had atrial tachycardia and one had intermittent atrial flutter/fibrillation with sinus bradycardia. During a mean observation period of 18 months, recurrent intermittent atrial fibrillation occurred in two patients. Another study reported the results of 20 patients with paroxysmal atrial fibrillation. During a mean observation period of 32 ± 14 months, one patient had a brief episode of atrial fibrillation and three patients had atrial tachycardia amenable to antiarrhythmic drug treatment. The 'Maze' operation was performed in 22 patients with resistent lone atrial fibrillation or atrial flutter. Postoperatively, eight patients had atrial flutter/fibrillation which, however, could be controlled in three with antiarrhythmic drug treatment. In all patients serious symptoms were improved but adjunctive measures and/or antiarrhythmic drugs were required frequently. There was no intraoperative mortality with either the corridor or the Maze operation but substantial postoperative morbidity was observed which, currently, exceeds that of the natural history or other ablative techniques.