HYBRID TWO-STEP APPROACH IN TREATMENT OF PATIENTS WITH CORONARY ARTERY DISEASE AND ATRIAL FIBRILLATION
A. Kovalev, S. Kovalev, L. Bokeria, A. Filatov, D. Gryaznov
1. Laboratory of intraoperative diagnosis and treatment of arrhythmias, Bakoulev Center for Cardiovascular Surgery, Moscow, Russian Federation; 2. Interregional Cardiac surgery department, Voronezh state hospital #1, Voronezh, Russian Federation
Introduction:The aim of the study was to compare the efficacy of simultaneous CABG and MAZE procedure and hybrid two-step approach with endocardial “box lesion” ablation
Methods: The two-center clinical cohort study was held in 2009-2013 and includes 96 patients with CAD and persistent AF. All patients underwent CABG procedure. The first group (58 patient) also passed through simultaneous MAZE-4 procedure. In the second group (38) endocardial ablation with the help of electroanatomical mapping of CFAE areas was held not later than 3 months after CABG. Follow-up was 2 years. All patients were on AAT for 3-6 months after the procedure.
Results: Hospital efficacy in group 1 was 81% (47 patients), in group 2 78,9% (30 patients). In the end of study efficacy was 77,6% and 71% respectively (p=0,658); cumulative HR was 0,99 (0,64;2,05) and 1,2 (0,77;2,73); NYHA I-II was in 70,7% and 68,4%; freedom from TIA was 94,8% (OR 4,5 (0,6;34,51)) and 86,8% (OR 7,14 (0,83;73,64)). Total mortality was 1,04%.
Conclusions: Hybrid two-step approach is AS effective as MAZE-4 in patients with CAD and CABG procedure.
