Medium-term outcome of different surgical methods to cure atrial fibrillation: is less worse?

Different lesion sets and ablation techniques have been performed. We compared these outcomes in search of the best method. We performed a retrospective analysis of patients who have undergone AF surgery different from the maze III. The surgical lesion sets were pulmonary vein isolation (PVI) alone, left atrial maze (LAM) and bi-atrial maze (BAM) and were made with different ablation techniques. During surgery one patient died due to bleeding of a pulmonary vein. The number of patients in the PVI-, LAM-, BAM-groups was 12, 28 and 26, respectively, with freedom from AF at latest follow-up w22.0"15.6 (3.1–81.2) monthsx of 33%, 59% and 60%, respectively. Atrial flutter occurred less in the BAM-group (4%) than in the left-sided procedures (15.4%) (Ps0.231). Multivariate analysis demonstrated a higher recurrence of AF for PVI alone (OR 4.42, CL 0.95–20.6, Ps0.0583) and a lower recurrence for the ‘cut-and-sew’ technique (OR 0.13, CL 0.030–0.60, Ps0.0084). Leftand bi-atrial maze procedures are equally effective in the suppression of AF, whereas omission of right-sided lesions results in a higher prevalence of atrial flutter. The ‘cut-and-sew’ technique is superior in terms of freedom from AF compared to bipolar and unipolar radiofrequency. 2008 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.