Long-term outcomes of stand-alone Maze IV for persistent/long-standing persistent atrial fibrillation

Publication date: Available online 17 July 2019Source: The Annals of Thoracic SurgeryAuthor(s): Elisabetta Lapenna, Michele De Bonis, Ilaria Giambuzzi, Benedetto Del Forno, Stefania Ruggeri, Manuela Cireddu, Simone Gulletta, Alessandro Castiglioni, Ottavio Alfieri, Paolo Della Bella, Stefano BenussiAbstractBackgroundTo assess the long-term outcomes of the stand-alone Cox-Maze IV procedure in symptomatic patients with refractory, persistent or long-standing persistent atrial fibrillation (AF).MethodsFifty-nine consecutive patients (mean age 52±10.5, previous catheter ablation 80%, LVEF 55±3.4%, median LA volume index 41[34;47]ml/m2) with symptomatic, refractory, persistent (56%) or longstanding persistent (44%) AF, underwent stand-alone Cox-Maze IV procedure. Biatrial ablations were performed with bipolar radiofrequency and cryoenergy. Left atrial appendage was excluded in 56/59 (95%) pts.ResultsNo hospital deaths occurred and one patient (1.7%) required postoperative pacemaker implantation. Follow-up was 97% complete (median 5.8 years, IQR3.92;7.11). The overall survival at 7-years was 97±2.3%. The 7-years Cumulative incidence function of AF recurrence and of AF recurrence off class I/III AADs, with death as competing risk, was 14.2±5.6% (95%CI 5.5;26.8) and 26.5±6.9% (95%CI 14.2;40.4), respectively. Multivariate analysis identified the duration of AF as the only predictor of AF recurrence (HR=1.01, 95%CI 1.01;1.02, p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Abstract BACKGROUND: To assess the long-term outcomes of the stand-alone Cox-Maze IV procedure in symptomatic patients with refractory, persistent or long-standing persistent atrial fibrillation (AF). METHODS: Fifty-nine consecutive patients (mean age 52±10.5, previous catheter ablation 80%, LVEF 55±3.4%, median LA volume index 41[34;47]ml/m2) with symptomatic, refractory, persistent (56%) or longstanding persistent (44%) AF, underwent stand-alone Cox-Maze IV procedure. Biatrial ablations were performed with bipolar radiofrequency and cryoenergy. Left atrial appendage was excluded in 56/59 (95%)...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
In this study, we elaborate on a tentative interpretation of the observed intermittent dynamics during AF as the signature of synaptic plasticity. Typical individual GJC transition times between open and closed states were shown to be much longer than those of membrane polarization but compare well with membrane recovery time (≳ 100ms) (Spray et al., 1984; Neyton and Trautmann, 1986; Wang et al., 1992; Bukauskas and Verselis, 2004; Desplantez et al., 2007). Moreover, slow gating modulations have been evidenced due to cytoplasmic protons (low pH) and free calcium (Spray et al., 1984; Burt and Sray, 1988; Kumar and Gilula,...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
This study shows that some genetic changes linked to cancer are present in surprisingly large numbers of normal cells. We still have a long way to go to fully understand the implications of these new findings, but as cancer researchers, we can't underestimate the importance of studying healthy tissue." Early Onset of Menopause Correlates with Shorter Life Expectancy https://www.fightaging.org/archives/2018/10/early-onset-of-menopause-correlates-with-shorter-life-expectancy/ Aging is a phenomenon affecting all organs and systems throughout the body, driven by rising levels of molecular damage. The v...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: . Combination of mini-invasive surgical and endocardial treatment (two-stage hybrid procedure) is a safe and effective method for the treatment of isolated (lone) AF. This procedure provided good midterm outcomes. PMID: 30214077 [PubMed - as supplied by publisher]
Source: Biomedical Papers of the Medical Faculty of the Univ Palacky Olomouc Czech Repub - Category: Biomedical Science Tags: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub Source Type: research
Conclusion In summary, although it is not possible to exclude confounding factors, the timing and dose-dependent effect of aripiprazole administration in our patient suggests an association between an initial intramuscular injection of long-acting aripiprazole and new onset of AF. This observation calls for clinical vigilance, not only in patients with additional risk factors for stroke but also in younger patients who might have predisposing factors for arrhythmias. References CPS (Canadian Pharmacists Association). Available at: http://www.e-therapeutics.ca. Accessed January 1, 2017. Polcwiartek C, Sneider B, Graff C,...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue adverse effects aripiprazole atrial fibrillation schizoaffective disorder Source Type: research
Conclusion: Atrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year. Discharge from hospital in sinus rhythm was a predictor of maintenance of this rhythm. Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm. Operative mortality rate of 7.7% and survival and stroke-free survival contribute to excellent care results for this approach.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Objective: To assess heart rhythm and predictive factors associated with sinus rhythm after one year in patients with rheumatic valve disease undergoing concomitant surgical treatment of atrial fibrillation. Operative mortality, survival and occurrence of stroke after one year were also evaluated.Methods: Retrospective longitudinal observational study of 103 patients undergoing rheumatic mitral valve surgery and ablation of atrial fibrillation using uni- or bipolar radiofrequency between January 2013 and December 2014. Age, gender, functional class (NYHA), type of atrial fibrillati...
Source: Brazilian Journal of Cardiovascular Surgery - Category: Cardiology Source Type: research
Conclusions Concomitant CM procedures performed with cryothermal energy alone or combined with bipolar radiofrequency ablation are safe and exceedingly effective. The association of cryothermal energy alone with higher rates of sinus rhythm and stroke reduction should be investigated further.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusion The thoracoscopic box-lesion ablation procedure is a safe, effective, and minimally invasive method for the treatment of isolated (lone) AF. This procedure provided excellent short-term freedom from AF.
Source: Cor et Vasa - Category: Cardiology Source Type: research
CONCLUSIONS: Concomitant CM procedures performed with cryothermal energy alone or combined with bipolar radiofrequency ablation are safe and exceedingly effective. The association of cryothermal energy alone with higher rates of sinus rhythm and stroke reduction should be investigated further. PMID: 28577848 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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