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Predictors of Sinus Rhythm after Radiofrequency Maze and Mitral Valve Surgery

Cardiothoracic Surgery Unit, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

For reprint information contact: Suchart Chaiyaroj, FACS, Tel: 66 2 201 1315, Fax: 66 2 201 1316, Email: schaiyaroj{at}gmail.com, Cardiothoracic Surgery Unit, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

The prevalence and predictors of postoperative sinus rhythm in patients undergoing a radiofrequency ablation maze operation and mitral valve surgery were assessed in 63 patients of whom 54 (86%) were in permanent atrial fibrillation. Operative mortality was 3.17%. At a median follow-up of 18 months, 54 (88.5%) patients were in sinus rhythm and 7 (11.5%) were in atrial fibrillation. The probability of sinus rhythm at 30 months was 92%. Left atrial diameter was the most significant prognostic factor for sinus rhythm on multivariate proportional-hazard regression analysis. The cutoff value of preoperative left atrial diameter for predicting persistent atrial fibrillation at 6 months was 6 cm (100% sensitivity and 73.6% specificity). The radiofrequency ablation maze operation can be performed in addition to mitral surgery with a high rate of successful conversion to sinus rhythm. Preoperative left atrial diameter < 6 cm is an important prognostic factor for sinus rhythm conversion.