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Clinical characteristics and ablation outcomes of recurrent atrial tachyarrhythmia after Maze operation -A multicenter study in Fukuoka
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  • Shunsuke Kawai,
  • Kazuo Sakamoto,
  • Atsushi Tanaka,
  • Shujiro Inoue,
  • Kazuhiro Nagaoka,
  • Hirohide Matsuura,
  • Susumu Takase,
  • Masatsugu Nozoe,
  • Kotaro Abe,
  • Yasushi Mukai,
  • Daisuke Yakabe
Shunsuke Kawai
Fukuoka Sekijuji Byoin
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Kazuo Sakamoto
Kyushu Daigaku - Byoin Campus
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Atsushi Tanaka
Saiseikai Fukuoka Sogo Byoin
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Shujiro Inoue
Iizuka Byoin
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Kazuhiro Nagaoka
St Mary’s Hospital of Kurume
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Hirohide Matsuura
Fukuoka Sekijuji Byoin
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Susumu Takase
Kyushu Daigaku - Byoin Campus
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Masatsugu Nozoe
Saiseikai Fukuoka Sogo Byoin
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Kotaro Abe
Kyushu Daigaku - Byoin Campus
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Yasushi Mukai
Fukuoka Sekijuji Byoin

Corresponding Author:y_mukai@junnai.org

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Daisuke Yakabe
Kyushu Daigaku - Byoin Campus
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Abstract

Backgrounds: Catheter ablation of recurrent atrial tachyarrhythmia after Maze operation is challenging due to complex arrhythmia circuits. The aim of this study was to clarify the characteristics and ablation outcomes of atrial tachyarrhythmias after Maze operation. Methods and Results: Twenty-eight cases who underwent catheter ablation of post-Maze procedure atrial tachyarrhythmia (42 sessions; 1.5 per patient) in our 5 teaching affiliate hospitals were retrospectively analyzed. Cox-Ⅳ Maze procedure and left atrial Maze were performed in 19 cases and 5 cases, respectively. Mean interval between the surgery and index ablation was 62.4 months. In total, 46 atrial tachyarrhythmias were studied. Reentrant atrial tachycardia (AT) was the most common form (n=36), whereas 4 atrial fibrillation (AF) and 2 focal AT were also observed. Identified tachyarrhythmia circuits were as follows; 16 peri-mitral, 9 left atrial localized reentry (4 septal, 3 posterior, 1 left atrial appendage, 1 anterior), 6 right atrial lateral incision-related, 5 cavo-tricuspid isthmus dependent, 3 roof dependent, 2 right atrial localized reentry (1 coronary sinus, 1 cavo-tricuspid isthmus), 1 bi-atrial reentry, 1 pulmonary vein-left atrial reentrant tachycardia, 2 focal AT (1 para-hisian, 1 coronary sinus), and 1 atrio-ventricular nodal reentry. Termination of targeted tachyarrhythmia was achieved in 34 sessions (81%). AT/AF recurrence free rate at 12, 24, 36 months of follow-up were 91.8%, 81.6%, and 65.3%, respectively. Seven cases underwent multiple sessions (two 2 nd sessions, three 3 rd sessions, and two 4 th sessions). In these cases, de-novo atrial tachyarrhythmias were detected in the repeat procedures. Conclusions: Most of the atrial tachyarrhythmias after Maze operation were incision/gap-related reentrant ATs, among which peri-mitral AT and LA localized reentry were the most prevalent. Although these challenging tachyarrhythmias can be treated with the contemporary mapping techniques, de-novo tachyarrhythmias can emerge in a remote period.
03 Jan 2025Submitted to Journal of Cardiovascular Electrophysiology
03 Jan 2025Submission Checks Completed
03 Jan 2025Assigned to Editor
03 Jan 2025Review(s) Completed, Editorial Evaluation Pending
13 Jan 2025Reviewer(s) Assigned