Surgery as an effective nonpharmacological mode of treatment of atrial fibrillation resistant to standard therapy.

There are two surgical methods for atrial fibrillation (AF) treatment: Maze and corridoring procedures. The first one prevents AF occurrence by performing multiple atriotomies. During the second procedure a corridor between a sino-atrial and the AV node is created together with an electrical isolation of the atria. During 1992 and 1993 seven patients, aged 27-55, mean 43-years-old, with recurrent, resistant to standard therapy AF were referred for surgical treatment to our department. Additional diagnoses include: concealed WPW syndrome in 1 patient, atrial septal defect (ASD) in 3 patients, coronary artery disease in 1 patient. Maze procedure was performed solely in 1 patient, in another together with 2 accessory pathways ablation, in 3 patients with ASD closure and in 1 patient with 2 bypass grafts. In one patient corridoring procedure was performed. Normal sinus rhythm was restored in every patient from 7 to 26 days after the procedure. No surgical complications were noted during the postoperative period. Mechanical function of the atria was documented with echo Doppler 2-6 weeks after the operation. No evidence for AF recurrence was noted within 3-14 months (mean 5 months) of follow-up. The preliminary results of Maze and corridoring procedures are encouraging.