Background : Short-term favorable outcome of Maze III surgery has been established but long-term results and risk factors for recurrence of atrial fibrillation (AF) are unclear.
Methods : Preoperative, in-hospital and follow–up data of 203 consecutive patients who underwent unmodified maze III procedure from June 1993 till June 2003, were retrospectively collected. 139 patients underwent the unmodified maze III for lone AF and 64 had concomitant surgical procedures.
Results : There was no 30-day mortality. During a mean follow-up period of 4.0 ± 2.6 years, 12 patients died of which two for cardiac reasons. Registration of arrhythmia was documented on ECG and not on patient's symptomatic information. Freedom of AF at last follow-up was 80.1% (81/136) for the lone AF group and 64.5% (40/62) for the concomitant group. Freedom of AF and of antiarrhythmic medication was 61.0% (83/136) for the lone AF group and 41.9% (26/62) for the concomitant group. Two patients in the concomitant group developed a CVA. Multivariate analysis showed that rhythm at 1 year follow-up (p<0.001) and preoperative left atrial dimension (p=0.028) were significant predictors for relapse of AF during follow-up.
Conclusions : This study confirms that favorable outcome of maze III procedure with and without additional cardiac surgery, persists for at least 4 years postoperatively; moreover this can be predicted at the end of the first year follow-up. This has significant relevance for preoperative patient information and postoperative patient care strategy.