Abstract
Cardiac adipose tissue is a well-known risk factor for the recurrence of atrial fibrillation (AF) after radiofrequency catheter ablation, but its correlation with maze surgery remains unknown. The aim of this study was to investigate the correlation between the recurrence of AF and the adipose component of the left atrium (LA) in patients who underwent a modified Cox maze (CM) III procedure. We reviewed the pathology data of resected LA tissues from 115 patients, including the adipose tissue from CM-III procedures. The mean follow-up duration was 30.05 ± 23.96 months. The mean adipose tissue component in the AF recurrence group was 16.17% ± 14.32%, while in the non-recurrence group, it was 9.48% ± 10.79% (p = 0.021), and the cut-off value for the adipose component for AF recurrence was 10% (p = 0.010). The rates of freedom from AF recurrence at 1, 3, and 5 years were 84.8%, 68.8%, and 38.6%, respectively, in the high-adipose group (≥10%), and 96.3%, 89.7%, and 80.3%, respectively, in the low-adipose group (<10%; p = 0.002). A high adipose component (≥10%) in the LA is a significant risk factor for AF recurrence after CM-III procedures. Thus, it may be necessary to attempt to reduce the perioperative adipose portion of the cardiac tissue using a statin in a randomized study.
Highlights
Published: 4 February 2022Atrial fibrillation (AF) is the most frequent heart rhythm disorder and is known to be associated with obesity, metabolic syndrome, and inflammation [1,2]
atrial fibrillation (AF) ablation is superior to mitral valve (MV) surgery alone with an intensive rhythm control strategy, and the potential benefits and safety of a surgical ablation procedure for AF during MV surgeries have been well documented [4]
Cox maze procedure include the restoration of synchronous atrioventricular contractions, leading to an improvement in cardiac output, the relief of palpitation symptoms, the prevention of thromboembolic events, and the discontinuation of anticoagulation therapy, which may improve the quality of life [3]
Summary
Atrial fibrillation (AF) is the most frequent heart rhythm disorder and is known to be associated with obesity, metabolic syndrome, and inflammation [1,2]. AF ablation is superior to MV surgery alone with an intensive rhythm control strategy, and the potential benefits and safety of a surgical ablation procedure for AF during MV surgeries have been well documented [4]. The benefits of one surgical ablation procedure called the. About 30–35% of patients who undergo maze procedures experience AF recurrence during follow-up [5]; many studies have attempted to reveal factors that can predict risk or failure, such as AF duration, left atrial size, and the degree of left atrial tissue fibrosis. Epicardial adipose tissue was recently shown to be associated
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