Mid-term outcomes of concomitant Cox-Maze IV: Results from a multicenter prospective registry.
Journal of cardiac surgery
washington; swedish; Aged; Atrial Fibrillation; Cardiac Surgical Procedures; Catheter Ablation; Female; Humans; Male; Registries; Treatment Outcome
BACKGROUND: Benefits of concomitant atrial fibrillation (AF) surgical treatment are well established. Cardiac societies support treating AF during cardiac surgery with a class I recommendation. Despite these guidelines, adoption has been inconsistent. We report results of routine performance of concomitant Cox-Maze IV (CMIV) from participating centers using a standardized, prospective registry.
METHODS: Nine surgeons at four cardiac surgery programs enrolled 807 patients undergoing concomitant CMIV surgery over 12 years. Lesions were created using bipolar radiofrequency clamps and cryoablation probes. Follow-up occurred at 3- and 6-months, then annually for 3 years. Freedom from AF was defined as no episode >30 s of atrial arrhythmia.
RESULTS: Sixty-four percent of patients were male, mean age 69 years, mean left atrial size 4.6 cm, mean preoperative AF duration 4.0 years, mean EuroSCORE 6.4, and mean CHADS
CONCLUSIONS: Routine CMIV is safe and effective. Acceptable outcomes can be achieved across multiple centers and multiple operators even in a moderate risk patient population undergoing more complex procedures. Surgeons and institutions should be encouraged by all cardiac societies to adopt the CMIV procedure to maximize patient benefit.
Gerdisch, Marc; Lehr, Eric J; Dunnington, Gansevoort; Johnkoski, John; Barksdale, Andrew; Parikshak, Manesh; Ryan, Patrick; Youssef, Samuel J; Fletcher, Robert; and Barnhart, Glenn R, "Mid-term outcomes of concomitant Cox-Maze IV: Results from a multicenter prospective registry." (2022). Articles, Abstracts, and Reports. 6431.