Surgical Management for Chronic Atrial Fibrillation.
- Author:
Gyung Hun KANG
1
;
Chul Hwan KIM
;
Byung Yeol KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, National Medical Center, Korea.
- Publication Type:Original Article
- Keywords:
Atrial fibrillation;
Surgery;
method
- MeSH:
Amiodarone;
Arrhythmias, Cardiac;
Atrial Fibrillation*;
Bradycardia;
Electrocardiography;
Heart Atria;
Humans;
Incidence;
Mortality;
Recurrence;
Sinoatrial Node
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(1):59-65
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.
