Surgical treatment of atrial fibrillation
Authors:
P. Němec
Authors‘ workplace:
Centrum kardiovaskulární a transplantační chirurgie, Brno
Published in:
Kardiol Rev Int Med 2009, 11(1): 8-10
Overview
Surgical treatment of atrial fibrillation. The interest about the atrial fibrillation (AF) treatment has been increased due to its’ importance as the most common cardiac arrhytmia. It occurs mainly in two groups of patients. There are older patients and patients with left ventricular dysfunction. The history of the surgical treatment of AF is more than 20 years long. The result of this long development is the “maze” operation. It consists of the system of linear transmural lesions on the atria. Their aim is to eliminate the ectopic activity and the interruption of the re‑entry circuits which are necessary for occurrence and maintenance of the sinus rhythm. The lesion can be performed surgically (cut-and-sew technique) or by means of alternative energy sources. The sinus rhythm is maintained in about 75–80% of patients after surgical treatment. But according to the literature the results are quite variable because of different conditions. The main parameters, which contribute to this difference are: character of the atrial fibrillation (paroxysmal persistent or permanent), the length of the permanent fibrillation, the size of the atria, the original heart disease and the extend of the surgical procedure (from pulmonary vein isolation to complex lesions on both atria).
Keywords:
atrial fibrillation – surgical treatment – maze operation
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