OBJECTIVE Surgical ablation procedures that use the Cox-Maze procedure lesion set were shown to be very effective. However, many surgeons are reluctant to perform the procedure, especially in high-risk patients such as those with reduced left ventricular (LV) function. This study explored the potential impact of the Cox-Maze III/IV procedure on patients with low ejection fraction (EF<40%) and s...

AIMS This study is the first prospective randomized trial evaluating the efficacy of an antiarrhythmic surgical procedure in patients with chronic atrial fibrillation undergoing mitral valve replacement. METHODS AND RESULTS Thirty consecutive patients with chronic atrial fibrillation undergoing mitral valve replacement were randomized for an additional modified MAZE-operation using intra-oper...

OBJECTIVE Although maze-related surgical procedures have shown success at eliminating atrial fibrillation, published controlled studies have generally been too small to detect clinically significant differences in morbidity and mortality. We pooled available studies to determine whether a simultaneous maze procedure reduces the risk of stroke or death in patients with chronic or paroxysmal atri...

BACKGROUND Autonomic ganglionated plexi (GPs) play a significant role in the initiation and maintenance of atrial fibrillation (AF). GPs are key targets for a maze procedure. The purpose of this study was to identify the location of the left atrial GPs based on dense epicardial mapping during a maze procedure in patients with concomitant AF. METHODS Sixteen patients (age, 68 ± 10 years; 11 ma...

Studies using the Morris water maze to assess hippocampal function in animals, in which adult hippocampal neurogenesis had been suppressed, have yielded seemingly contradictory results. Cyclin D2 knockout (Ccnd2(-/-)) mice, for example, have constitutively suppressed adult hippocampal neurogenesis but had no overt phenotype in the water maze. In other paradigms, however, ablation of adult neuro...

BACKGROUND Ganglionated plexi ablation during atrial fibrillation surgery is not technically standardized for precise ganglionated plexi locations or ablation sequence. We aimed to identify precise active ganglionated plexi locations in patients with structural heart disease and explore the feasibility of anatomic ganglionated plexi ablation without prior mapping in patients with atrial fibrill...

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, which can induce cardiac dysfunction and strokes, causing a substantial socioeconomic burden. Patients with AF undergoing cardiac surgery have an increased risk of ventricular dysfunction, comorbidities, and mortality. Eradicating AF during cardiac surgery could decrease the number of adverse cardiovascular eve...

A 74-year-old woman who developed atrial tachycardia following the Cox-Maze IV procedure underwent catheter ablation. The reentrant circuit included the coronary sinus (CS), Marshall bundle (MB), distal MB-left atrial (LA) connection, and anterolateral mitral annulus. The distal MB-LA connection was the last barrier in the conduction pathway between the CS and the left atrium.

BACKGROUND The aim of this study was to evaluate the impact of ablation duration during a maze procedure using a nitrous oxide-based cryosurgical system. METHODS From May 2001 to December 2006, 256 consecutive patients who underwent a concomitant maze procedure using nitrous oxide-based cryoablation for chronic atrial fibrillation (AF) during cardiac surgery were enrolled. The ablation durati...

Our cardiac surgical program performs 1,200 cardiopulmonary bypass (CPB) procedures annually with approximately 100120 [50% of patients who present with atrial fibrillation (AF)] of these patients undergoing an AF surgical ablation (SA) procedure concomitant to their cardiac surgical operation. Furthermore, we also perform stand-alone surgical ablation for AF as an isolated procedure for patien...