Surgical ablation for atrial fibrillation for two decades: Are the results of new techniques equivalent to the Cox maze III procedure? John M. Stulak,

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Presentation transcript:

Surgical ablation for atrial fibrillation for two decades: Are the results of new techniques equivalent to the Cox maze III procedure? John M. Stulak, MD, Rakesh M. Suri, MD, DPhil, Harold M. Burkhart, MD, Richard C. Daly, MD, Joseph A. Dearani, MD, Kevin L. Greason, MD, Lyle D. Joyce, MD, PhD, Soon J. Park, MD, Hartzell V. Schaff, MD The Journal of Thoracic and Cardiovascular Surgery Volume 147, Issue 5, Pages 1478-1487 (May 2014) DOI: 10.1016/j.jtcvs.2013.10.084 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Types of lesion sets performed according to year. An increase was seen in focal lesion sets (pulmonary vein isolation [PVI] and left atrial [LA]) throughout the study period. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Energy sources used according to year. An increase was seen in alternate energy sources (radiofrequency [RF], cryothermy [Cryo], and combined) through the study period. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 The use of the classic cut and sew Cox maze III (CSM) procedure according to year. An increase was seen in the use of alternative lesion sets and energy sources throughout the study period. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Overall freedom from atrial fibrillation without antiarrhythmic medication (%) at each follow-up point according to type of ablative energy source. Cut and sew was superior at each follow-up interval (P = .01, P = .03, and P < .001, respectively). Cryo, Cryothermy; RF, radiofrequency. *Statistically significant difference. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Overall freedom from atrial fibrillation without antiarrhythmic medication (%) at each follow-up interval according to the type of lesion set. Biatrial and complete left atrial (LA) lesion sets were superior at >5 years postoperatively (P = .004). *Statistically significant difference. PVI, Pulmonary vein isolation. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Freedom from atrial fibrillation without antiarrhythmic medication (%) at each follow-up interval according to type of ablative energy performed for patients who underwent isolated mitral valve surgery. Cut and sew was associated with significantly greater freedom from atrial fibrillation without antiarrhythmic medication after 5 years postoperatively (P = .03). *Statistically significant difference. The Journal of Thoracic and Cardiovascular Surgery 2014 147, 1478-1487DOI: (10.1016/j.jtcvs.2013.10.084) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions