Long Term Follow-up of the MAZE Procedure for Treatment of Chronic Atrial Fibrillation: Results after 3 Years

Background: The MAZE operation using microwave or radiofrequency to create atrial ablation lines is an established procedure in the treatment of chronic atrial fibrillation. This study investigates long term results after 36 months. Methods: Between 2/2001 and 12/2002 42 patients (mean age 64.5 +/- 2.2 years, 21 male, 21 female) with chronic permanent atrial fibrillation > 6 months and additional heart valve(s) disease underwent mitral valve replacement/repair +/- tricuspid valve repair (n = 30), aortic valve replacement +/- tricuspid valve repair (n = 6) and double valve replacement/repair +/- tricuspid valve reconstruction together with the MAZE procedure. Mean duration of atrial fibrillation was 63 +/- 29 months (7-384 months). Microwave or radiofrequency was used to create linear lesions in both atria according to the Cox III concept. Results: The MAZE procedure required 23 +/- 2 minutes additional aortic cross clamp time (total: 89 +/- 3 min). ICU stay was prolonged in one patient due to SIRS. The remaining patients were extubated 18.3 +/- 6.7 hours postoperatively. Mean ICU stay was 1.7 +/- 0.6 days. 52,3 % were treated with amiodaron, 64,3 % underwent cardioversion. 23,8 % required a permanent pacemaker due to AV-block or sick sinus syndrome. 12 months postoperative freedom from atrial fibrillation was 80,8 %. At the last follow-up (36 +/- 8 months) 78,6 % of all patients were free from atrial fibrillation. Conclusions: Only minimal surgical risk is associated with the MAZE procedure following the Cox III concept using microwave or radiofrequency energy. Freedom from atrial fibrillation is almost identical 1 and 3 years postoperatively. Thus it is possible to provide stable long term sinus rhythm for patients with chronic atrial fibrillation.