PMID- 21329840
OWN - NLM
STAT- MEDLINE
DCOM- 20130807
LR  - 20220330
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 57
IP  - 8
DP  - 2011 Feb 22
TI  - Impact of lesion sets on mid-term results of surgical ablation procedure for 
      atrial fibrillation.
PG  - 931-40
LID - 10.1016/j.jacc.2010.09.055 [doi]
AB  - OBJECTIVES: The objective of this study was to evaluate the effects of different 
      lesion sets of ablation in patients undergoing mitral surgery plus maze. 
      BACKGROUND: The role of lesion sets on outcome after maze is poorly defined. 
      METHODS: A total of 141 patients were prospectively followed up. Two different 
      lesion sets were prepared: 32 patients underwent a radiofrequency left atrial 
      lesion set of maze ("limited"), and 109 had combined left and right atrial lesion 
      sets of maze +/- ganglionic plexi isolation ("extensive"). A longitudinal 
      observational study assessed the role of "extensive" versus "limited" ablation on 
      atrial fibrillation (AF), New York Heart Association (NYHA) functional class 
      II/III, treatment with antiarrhythmic drugs, follow-up recovery of the ratio of 
      E- to A-wave (E/A), and survival and time to hospitalization (overall and for 
      heart failure). RESULTS: The prevalence of AF over time was lower in the 
      "extensive" arm (adjusted relative risk [RR]: 0.10; 95% confidence interval [CI]: 
      0.03 to 0.31; p < 0.001), with significantly lower prevalence at discharge, 3 
      months, and 18 months. The prevalence of patients in NYHA functional class II/III 
      over time was lower in the "extensive" arm (adjusted RR: 0.11; 95% CI: 0.03 to 
      0.34; p < 0.001), with significant differences at any assessment (except the 
      third month). The differences in E/A recovery and use of antiarrhythmic drugs 
      were less marked, with an RR of 1.55 (95% CI: 0.99 to 2.42; p = 0.05) and RR of 
      0.76 (95% CI: 0.54 to 1.06; p = 0.11), respectively, with a significantly lower 
      prevalence of antiarrhythmic drugs in the "extensive" ablation arm at 12, 18, and 
      24 months. Rates of hospitalization for heart failure, overall hospitalization, 
      and the combined event death/hospitalization were lower in the "extensive" arm (p 
      = 0.11, p = 0.003, and p = 0.002, respectively). CONCLUSIONS: The addition of 
      right-sided ablation improves clinical and electrophysiologic results after maze 
      procedure.
CI  - Copyright (c) 2011 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Onorati, Francesco
AU  - Onorati F
AD  - Division of Cardiac Surgery, University of Verona Medical School, Italy. 
      frankono@libero.it
FAU - Mariscalco, Giovanni
AU  - Mariscalco G
FAU - Rubino, Antonino Salvatore
AU  - Rubino AS
FAU - Serraino, Filiberto
AU  - Serraino F
FAU - Santini, Francesco
AU  - Santini F
FAU - Musazzi, Andrea
AU  - Musazzi A
FAU - Klersy, Catherine
AU  - Klersy C
FAU - Sala, Andrea
AU  - Sala A
FAU - Renzulli, Attilio
AU  - Renzulli A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2011 Jul 5;58(2):200-1; author reply 201. PMID: 21718923
MH  - Age Distribution
MH  - Aged
MH  - Atrial Fibrillation/diagnosis/*mortality/*surgery
MH  - Catheter Ablation/adverse effects/*methods
MH  - Cohort Studies
MH  - Confidence Intervals
MH  - Electrocardiography/methods
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Perioperative Care/methods
MH  - Postoperative Complications/mortality/physiopathology
MH  - Prognosis
MH  - Recurrence
MH  - Severity of Illness Index
MH  - Sex Distribution
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/02/19 06:00
MHDA- 2013/08/08 06:00
CRDT- 2011/02/19 06:00
PHST- 2010/06/15 00:00 [received]
PHST- 2010/09/10 00:00 [revised]
PHST- 2010/09/17 00:00 [accepted]
PHST- 2011/02/19 06:00 [entrez]
PHST- 2011/02/19 06:00 [pubmed]
PHST- 2013/08/08 06:00 [medline]
AID - S0735-1097(10)04804-7 [pii]
AID - 10.1016/j.jacc.2010.09.055 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2011 Feb 22;57(8):931-40. doi: 10.1016/j.jacc.2010.09.055.