Watanabe Michiko, Kohno Hiroki, Kondo Yusuke, Ueda Hideki, Ishida Keiichi, Tamura Yusaku, Abe Shinichiro, Sato Yasunori, Kobayashi Yoshio, Matsumiya Goro
Department of Cardiovascular Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
Surg Today. 2018 Sep;48(9):875-882. doi: 10.1007/s00595-018-1672-5. Epub 2018 May 18.
Very few studies have investigated the efficacy of ganglionated plexus ablation during the conventional maze procedure. In this study, we sought to evaluate its additive effect in reducing recurrent atrial fibrillation after concomitant maze surgery.
A retrospective study was conducted of 79 patients who underwent Cox maze IV concomitantly with open-heart surgery with (GP group) or without (Maze group) ganglionated plexus mapping. All active ganglionated plexuses were ablated. The two groups were compared and their follow-up data were analyzed.
Active ganglionated plexuses were found in 81% of patients who underwent ganglionated plexus mapping. The rates of freedom from atrial fibrillation at 1 year in the GP and Maze groups were 77 and 75%, respectively. The cumulative freedom from atrial fibrillation at follow-up (27.7 ± 17.3 months) was comparable in the two groups (p = 0.427). A multivariate analysis revealed that persistent atrial fibrillation for more than 90 months was an independent predictor of recurrent atrial fibrillation.
Ganglionated plexus ablation with Cox maze IV did not reduce the incidence of recurrent atrial fibrillation in comparison to Maze alone.
极少有研究探讨在传统迷宫手术中进行神经节丛消融的疗效。在本研究中，我们试图评估其在同期迷宫手术后减少房颤复发方面的附加效果。
对79例行心脏直视手术同期接受Cox迷宫IV手术且有（神经节丛组）或无（迷宫组）神经节丛标测的患者进行回顾性研究。所有活跃的神经节丛均被消融。对两组进行比较并分析其随访数据。
在接受神经节丛标测的患者中，81%发现有活跃的神经节丛。神经节丛组和迷宫组1年时的无房颤率分别为77%和75%。两组随访时（27.7±17.3个月）的累积无房颤率相当（p = 0.427）。多因素分析显示，持续性房颤超过90个月是房颤复发的独立预测因素。
与单纯迷宫手术相比，Cox迷宫IV联合神经节丛消融并未降低房颤复发的发生率。
