Persistent Atrial Fibrillation is Associated with Inability to Recover Atrial Contractility after MAZE IV Surgery in Rheumatic Disease

被引:11
作者
Tinetti, Matias [1 ]
Costello, Ramiro
Cardenas, Cesar
Piazza, Antonio
Iglesias, Ricardo
Baranchuk, Adrian [2 ]
机构
[1] Sanat Trinidad Palermo, Dept Cardiol & Echocardiog, Div Cardiol, Buenos Aires, DF, Argentina
[2] Queens Univ, Heart Rhythm Serv, Kingston Gen Hosp, Kingston, ON, Canada
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 2012年 / 35卷 / 08期
关键词
atrial fibrillation; MAZE surgery; rheumatic disease; atrial contractility; RHYTHM MANAGEMENT; CARDIOMYOPATHY; EFFICACY; IMPACT;
D O I
10.1111/j.1540-8159.2012.03458.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: MAZE IV surgery is effective in restoring sinus rhythm (SR) and atrial contraction (AC) in patients with nonrheumatic persistent atrial fibrillation (AF). However, there is less information on its effectiveness to restore AC in patients with rheumatic disease. Aims: To assess the effectiveness of the MAZE IV surgery in restoring AC in patients with rheumatic disease and long persistent AF. Methods: Prospective, consecutive study in patients who underwent cardiovascular surgery and had long persistent AF in whom MAZE IV surgery was performed. The presence of AC was assessed by lateral mitral annulus tissue Doppler. Results: A total of 75 patients were included. Mean age 60 years (+/-11.7); 27 men (36%). AF duration was 63 months (+/- 34.1). Primary indication for surgery: rheumatic mitral stenosis 67 patients and mitral insufficiency eight patients. Mean left ventricular ejection fraction (LVEF) was 51.8% (+/-12.1) and mean left atrial area was 37 cm2 (+/-10.3). After a mean follow-up of 28 months (+/-9.3), 69 patients remained alive and 59 were in SR. AC was detected in 37.3% (Group A) and absent in 62.7% (Group B). The mean difference between groups was the high prevalence of AF longer than 5 years in group B (P = 0.000001). There were no differences related to left atrial size, LVEF, and age. Conclusions: In patients with rheumatic disease, the absence of correlation between SR recovery and AC recovery post MAZE IV surgery is significant. A history of long persistent AF lasting more than 5 years was a strong predictor for the absence of AC. (PACE 2012; 35:999-1004)
引用
收藏
页码:999 / 1004
页数:6
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