Preliminary results with the microwave-modified maze III procedure for the treatment of chronic atrial fibrillation.

Between February 2003 and January 2004 a microwave-modified Maze III procedure was performed as an associated procedure in nine patients in chronic atrial fibrillation undergoing surgery for heart valve disease. Clinical follow-up was carried out in all survivors, and an echocardiographic assessment done in all those in sinus rhythm, during the first week of February 2004. There were six women and three men with a mean age of 60 +/- 9.4 years. Their rhythm at the end of surgery was sinus in 2 patients, nodal in 4, and complete AV block in 3. One patient died in hospital and there patients had no other complications related to the procedure. By the time of hospital discharge, four patients were in sinus rhythm and four were in atrial fibrillation. After a mean follow-up of 5.2 +/- 3.3 months there were no late deaths, 5 patients were in sinus rhythm, 1 required a permanent pacemaker in DDDR mode for persistent sinus bradycardia, and 2 remained in atrial fibrillation. Echocardiographic assessment, performed at a mean of 4.9 +/- 2.5 months after surgery in all patients in sinus rhythm or with a pacemaker, demonstrated biatrial contraction in five patients. The Cox-Maze III procedure can be performed safely and with good results using microwave energy instead of the conventional "cut and sew" technique.