Surgical Treatment of Atrial Fibrillation Concomitant to Coronary Artery Bypass Grafting: In-Hospital and Long-Term Results of Maze V Procedure

Aim: To assess the efficacy and safety of Maze V procedure for treating atrial fibrillation (АF) concomitant to coronary artery bypass grafting (CABG).

Methods: 82 patients with coronary artery disease and concomitant AF were recruited in a single-center study. Patients received hypothermia during on-pump CABG with warm blood hyperkalemia cardioplegia. Maze V was routinely performed before CABG under parallel perfusion without aortic cross-clamping. The primary and secondary endpoints included recurrent arrhythmia, sinus rhythm at discharge and in the long-term period, permanent pacemaker implantation, major cardiovascular and cerebrovascular events (MACCE).

Results: The in-hospital mortality rate was 2.4% (2 patients). The recurrence rate of AF/AFl after surgery was 23.1%. Stable sinus rhythm at discharge was recorded in 92.4% of patients. There were no unfavorable cardiovascular and cerebrovascular events during the in-hospital period. The median follow-up was 30.5[18.2;47.7] months. The cumulative freedom from AF/AFl without antiarrhythmic therapy after 12 months was 91%, after 24 months – 88%, and after 48 months 77%. The freedom from MACCE was 94%.

Conclusion: Maze V procedure is a safe and effective procedure for treating concomitant AF without any adverse events in the postoperative period. It has demonstrated favorable results in maintaining the sinus rhythm, both in the in-hospital and long-term period. Therefore, Maze V procedure should be considered for treating AF in patients undergoing CABG.

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