Pii: S1010-7940(01)00595-4

Objective: Patients with mitral valve disease and suffering of atrial ®brillation of more than 1 year's duration have a low probability of remaining in sinus rhythm after valve surgery alone. Intraoperative radiofrequency ablation was used as an alternative to simplify the surgical maze procedure. Methods: Seventy-two patients with mitral valve disease, aged 63 ^ 11 years ranging from 31 to 80 years, underwent valve surgery and radiofrequency energy applied endocardially, based on the maze III procedure to eliminate the arrhythmia. The right-sided maze was performed on the beating heart and the left-sided maze during aorta cross-clamping. Results: Surgical procedures included mitral valve repair (n ˆ 38) or replacement (n ˆ 34) and in addition tricuspid valve repair (n ˆ 42), closure of an atrial septal defect (n ˆ 2) and correction of cor triatriatum (n ˆ 1). The left-sided maze needed 14 ^ 3 min extra ischemic time. There were two in-hospital deaths (2.7%) and three patients (4.2%) died during follow-up of 20 ^ 15 months. Among 67 surviving patients, 51 patients (76%) were in sinus rhythm, two patients (3%) had an atrial rhythm and eight patients (12%) had persistent atrial ®brillation or atrial ̄utter. Four patients had a pacemaker implanted, in one patient because of sinus node dysfunction. Doppler echocardiography in 64 patients demonstrated right atrial contractility in 89% and left atrial transport in 91% of patients. Conclusions: Intraoperative radiofrequency ablation of atrial ®brillation is an effective and less invasive alternative for the original maze procedure to eliminate atrial ®brillation. q 2001 Elsevier Science B.V. All rights reserved.