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ORIGINAL ARTICLE
Year : 2019  |  Volume : 2  |  Issue : 4  |  Page : 311-318

A comparison between monopolar radiofrequency ablation and electrocautery (Diathermy) ablations in left modified MAZE (short-term results)


Department of Cardiac Surgery, National Heart Institute, Cairo, Egypt

Correspondence Address:
Waleed El-Awady
Department of Cardiac Surgery, National Heart Institute, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JMISR.JMISR_51_18

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Introduction Atrial fibrillation is the most common cardiac arrhythmia and is associated with significant morbidity and mortality. The classic cut-and-sew maze procedure is successful in 85–95% of patients. However, it is technically challenging and requires prolonged cardiopulmonary bypass. The left modified maze procedure is successful in 65–85% of patients. The aim of this study was to compare the success of two different ablation sources in the left modified MAZE. Patients and methods Between June 2010 and December 2016, 40 patients underwent left modified MAZE (Cox III) procedure: 20 patients were done with monopolar radiofrequency ablation (group A) and the other 20 patients were done with diathermy as electrocautery ablation (group B). All patients had left maze plus a concomitant operation. Results The patients' mean age was 38.2 ± 12.7 years; there was no mortality or stroke or any thromboembolic events in both groups. There were 14 (35%) males and 26 (65%) females. The mean left atrial size ranged from 62.6 to 27.4 mm. The mean cardiopulmonary bypass (CPB) time was 115.1 ± 84.9 min. The mean cross-clamp time was 86 ± 64 min. The incidence of freedom from atrial fibrillation was 45% at the end of the operation (40% of patients with normal sinus rhythm with group A and 50% with group B), and after 1-year follow-up, this incidence increased to 67.5%, with 70% in group A and 65% in group B; only one patient required permanent pacemaker. Conclusion Although monopolar radiofrequency ablation is slightly superior to electrocautery, diathermy is definitely a cheaper option and can be used with satisfactory considerable short-term results in left modified Maze procedure in case of absence of standard devices of ablation.


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