ArticleJTCVS open2025
Incomplete ablation as a mechanism of atrial fibrillation recurrence and atrial tachycardia development after maze procedure.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Delayed reconnection of the posterior wall inferior line after biatrial Cox-Maze IV despite previously confirmed bidirectional block.HeartRhythm case reports · 2026Article
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6 authors.
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Abstract
Objective: Atrial tachyarrhythmias are the most frequent complication after the maze procedure. We examined the mechanism of atrial tachyarrhythmias in association with the ablation energy and technique used at each lesion and by the findings of postoperative electrophysiological study. Methods: Four-hundred fifty-three patients who underwent the maze procedure with biatrial incisions and bilateral pulmonary vein (PV) isolation were examined for the incidence and mechanism of recurrence of atrial fibrillation (AF) and development of atrial tachycardia (AT). PV isolation was performed by radiofrequency (RF) ablation, cryothermia, or cut-and-sew technique. The atrioventricular isthmi and the coronary sinus (CS) were ablated by RF, cryothermia, or a combination of these. Results: Of 443 patients who survived surgery (98%), 54 patients (12.2%) had recurrent AF and 36 patients (8.1%) developed AT during the median of 28 months (interquartile range, 3-75) postoperatively. Multivariate logistic regression analysis showed preoperative left atrial dimension and nonperformance of intraoperative PV pacing were the independent predictors for AF recurrence. Electrophysiologic study in patients with AT demonstrated incomplete ablation in 24 patients (67%), most frequently at the CS in 16 patients (67%), and non-PV focal activations in 16 patients (44%). Preoperative New York Heart Association functional class of 1 and nonperformance of additional epicardial ablation of the CS were the independent predictors for postoperative AT development. Conclusions: Incomplete ablation is a cause of AF recurrence and AT development after the maze procedure. Intraoperative PV pacing prevents AF recurrence and additional epicardial CS ablation prevents AT development.
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