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General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 10/2022

27-04-2022 | Neurotomy | Original Article

Multicenter randomized study evaluating the outcome of ganglionated plexi ablation in maze procedure

Authors: Shun-Ichiro Sakamoto, Yosuke Ishii, Toshiaki Otsuka, Masataka Mitsuno, Tomoki Shimokawa, Tadashi Isomura, Hitoshi Yaku, Tatsuhiko Komiya, Goro Matsumiya, Takashi Nitta

Published in: General Thoracic and Cardiovascular Surgery | Issue 10/2022

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Abstract

Objective

The benefit of adding ganglionated plexi ablation to the maze procedure remains controversial. This study aims to compare the outcomes of the maze procedure with and without ganglionated plexi ablation.

Methods

This multicenter randomized study included 74 patients with atrial fibrillation associated with structural heart disease. Patients were randomly allocated to the ganglionated plexi ablation group (maze with ganglionated plexi ablation) or the maze group (maze without ganglionated plexi ablation). The lesion sets in the maze procedure were unified in all patients. High-frequency stimulation was applied to clearly identify and perform ganglionated plexi ablation. Patients were followed up for at least 6 months. The primary endpoint was a recurrence of atrial fibrillation.

Results

The intention-to-treat analysis included 69 patients (34 in the ganglionated plexi ablation group and 35 in the maze group). No surgical mortality was observed in either group. After a mean follow-up period of 16.3 ± 7.9 months, 86.8% of patients in the ganglionated plexi ablation group and 91.4% of those in the maze group did not experience atrial fibrillation recurrence. Kaplan–Meier atrial fibrillation–free curves showed no significant difference between the two groups (P = .685). Cox proportional hazards regression analysis indicated that left atrial dimension was the only risk factor for atrial fibrillation recurrence (hazard ratio: 1.106, 95% confidence interval 1.017–1.024, P = .019).

Conclusion

The addition of ganglionated plexi ablation to the maze procedure does not improve early outcome when treating atrial fibrillation associated with structural heart disease.
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Metadata
Title
Multicenter randomized study evaluating the outcome of ganglionated plexi ablation in maze procedure
Authors
Shun-Ichiro Sakamoto
Yosuke Ishii
Toshiaki Otsuka
Masataka Mitsuno
Tomoki Shimokawa
Tadashi Isomura
Hitoshi Yaku
Tatsuhiko Komiya
Goro Matsumiya
Takashi Nitta
Publication date
27-04-2022
Publisher
Springer Nature Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 10/2022
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-022-01820-8

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