How do we spell maze? A dialogue concerning definitions and goals

The Journal of thoracic and cardiovascular surgery (Impact Factor: 4.17). 01/2007; 132(6):1253-5. DOI: 10.1016/j.jtcvs.2006.08.046
Source: PubMed
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    ABSTRACT: Surgical ablation of atrial fibrillation has gained widespread acceptance, particularly in patients having concomitant cardiac surgery. Today, surgeons can choose from a variety of ablation technologies to facilitate operations intended to treat atrial fibrillation. Evidence suggests that virtually all of the available energy sources are effective at creating lines of conduction block on the arrested heart. However, there is controversy surrounding the choice of lesion set when these new devices are used. The purpose of this review is to address the critical question of lesion set by detailed consideration of contemporary data focusing on the (1) pathogenesis of atrial fibrillation, (2) results of catheter ablation, and (3) results of surgical ablation.
    The Annals of thoracic surgery 12/2007; 84(5):1786-92. DOI:10.1016/j.athoracsur.2007.05.040 · 3.85 Impact Factor
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    ABSTRACT: Atrial fibrillation (AF) is present in 30-50% of patients presenting for mitral valve surgery. If left untreated, AF in these patients is associated with increased morbidity and, possibly, increased mortality. Therefore, concomitant management of the arrhythmia is indicated in most mitral valve patients with preexisting AF. The cut-and-sew Cox-Maze III procedure is extremely effective, eliminating AF in 80-95%; however, it has been supplanted by newer operations that rely upon alternate energy sources to create lines of conduction block. Early and midterm results are good with a variety of technologies. Choice of lesion set remains a matter of debate, but success of ablation appears to be enhanced by a biatrial lesion set and exceeds 90% in some series. Targeted areas for improvement in combined mitral valve surgery and AF ablation include acceptance of uniform standards for reporting results, development of improved technology for ablation and intraoperative assessment, and creation of instrumentation that facilitates minimally invasive approaches.
    Journal of Interventional Cardiac Electrophysiology 01/2008; 20(3):101-7. DOI:10.1007/s10840-007-9171-4 · 1.58 Impact Factor
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