Cox maze IV versus left atrial reduction for atrial contraction restoration

2019 ◽  
Vol 27 (5) ◽  
pp. 353-361
Author(s):  
Dena K Firmansyah ◽  
Amiliana M Soesanto ◽  
Dicky A Hanafy ◽  
Arinto Bono
Keyword(s):  
Mitral Valve ◽  
Sinus Rhythm ◽  
Conversion Rate ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Maze Procedure ◽  
Volume Index ◽  
Filling Fraction ◽  
Left Atrial Volume Index ◽  
Atrial Contraction

Background The Cox maze procedure is the gold-standard concomitant surgical procedure to restore sinus rhythm in rheumatic mitral valve disease with atrial fibrillation. Left atrial reduction surgery was found to be beneficial for rhythm conversion, but no study has investigated its efficacy compared to the Cox maze procedure for atrial contractility restoration. We aimed to compare the early success rate of left atrial contractility restoration with the Cox maze procedure and left atrial reduction in rheumatic subjects. Methods Preoperative and within one-month postoperative electrocardiograms and echocardiograms of patients who underwent a Cox maze IV procedure or left atrial reduction with mitral valve surgery were compared. Effective atrial contraction was defined as A wave peak velocity ≥10 cm·s−1 or atrial filling fraction ≥20%. Results Ninety patients (mean age 40.6 ± 10.2 years, 66.7% female) were divided equally into group A (Cox maze IV) and group B (left atrial reduction). The early sinus rhythm conversion rate was 64.4% versus 24.4% ( p < 0.001) in groups A and B, respectively. In patients with restored sinus rhythm, contractility was restored in 41.4% and 36.4% ( p = 1.000). Postoperative left atrial volume index ≤76 mL·m−2 was an independent variable associated with early atrial contractility restoration in both groups (prevalence rate 0.97, p = 0.007). Conclusions In rheumatic subjects, the early sinus rhythm conversion rate was significantly higher after Cox maze IV compared to left atrial reduction, but for restoring left atrial contractility, left atrial reduction was not inferior to Cox maze IV.

Relationship between left atrial volume index and cognitive decline in elderly patients with sinus rhythm

2013 ◽  
Vol 20 (8) ◽  
pp. 1074-1078 ◽  
Author(s):  
Berrin Karadag ◽  
Tolga Ozyigit ◽  
Beste Ozben ◽  
Semra Kayaoglu ◽  
Yuksel Altuntas
Keyword(s):  
Elderly Patients ◽  
Sinus Rhythm ◽  
Cognitive Decline ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

Prognostic Implications of Left Atrial Volume Index in Patients in Sinus Rhythm

2010 ◽  
Vol 105 (11) ◽  
pp. 1635-1639 ◽  
Author(s):  
Dominic Y. Leung ◽  
Cecilia Chi ◽  
Christine Allman ◽  
Anita Boyd ◽  
Arnold C. Ng ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Prognostic Implications

scholarly journals Clinical determinants of early spontaneous conversion to sinus rhythm in patients with atrial fibrillation

2021 ◽  
Author(s):  
N. A. H. A. Pluymaekers ◽  
E. A. M. P. Dudink ◽  
B. Weijs ◽  
K. Vernooy ◽  
D. E. J. Hartgerink ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Standard Of Care ◽  
Volume Index ◽  
Current Standard ◽  
Left Atrial Volume Index ◽  
First Onset ◽  
Spontaneous Conversion

Abstract Background The current standard of care for acute atrial fibrillation (AF) focuses primarily on immediate restoration of sinus rhythm by cardioversion, although AF often terminates spontaneously. Objective To identify determinants of early spontaneous conversion (SCV) in patients presenting at the emergency department (ED) because of AF. Methods An observational study was performed of patients who visited the ED with documented AF between July 2014 and December 2016. The clinical characteristics and demographics of patients with and without SCV were compared. Results We enrolled 943 patients (age 69 ± 12 years, 47% female). SCV occurred within 3 h of presentation in 158 patients (16.8%). Logistic regression analysis showed that duration of AF <24 h [odds ratio (OR) 7.7, 95% confidence interval (CI) 3.5–17.2, p < 0.001], left atrial volume index <42 ml/m2 (OR 1.8, 95% CI 1.2–2.8, p = 0.010), symptoms of near-collapse at presentation (OR 2.4, 95% CI 1.2–5.1, p = 0.018), a lower body mass index (BMI) (OR 0.9, 95% CI 0.91–0.99, p = 0.028), a longer QTc time during AF (OR 1.01, 95% CI 1.0–1.02, p = 0.002) and first-detected AF (OR 2.5, 95% CI 1.6–3.9, p < 0.001) were independent determinants of early SCV. Conclusion Early spontaneous conversion of acute AF occurs in almost one-sixth of admitted patients during a short initial observation in the ED. Spontaneous conversion is most likely to occur in patients with first-onset, short-duration AF episodes, lower BMI, and normal left atrial size.

scholarly journals P1506 The correlation between left atrial volume index and cerebrovascular stroke

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Almaghraby ◽  
M Abdelnabi ◽  
T Kemaloglu Oz ◽  
Y Saleh ◽  
H Shehata ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Control Group ◽  
P Value ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Cerebrovascular Stroke

Abstract OnBehalf YIG-CVR Introduction Increased left atrial (LA) size was associated with poor cardiovascular outcomes such as the development of heart failure, atrial fibrillation (AF), and stroke in the elderly. Aim of the work To determine the relation between left atrial volume index (LAVI) and the occurrence of ischemic cerebrovascular stroke (CVS) in patients with sinus rhythm. Patients and Methods A prospective analysis of the data of patients admitted to a tertiary care center. Left atrial volume index (LAVI) was measured in 1222 patients admitted to our center with first attack of acute ischemic cerebrovascular stroke (CVS) and the data was matched with 1222 patients admitted by diagnoses other than acute ischemic stroke. Patients with valvular heart diseases, history of AF and with known cardio-embolic source of stroke as left ventricular thrombi or masses were excluded from both groups. Results The mean age was 61.1 ± 14.4 years in the CVS group and 61.5 ± 12.4 years in the control group, males were 806 (71.43%) in the CVS group and 852 (73.47%) in the control group. LAVI was 35 ± 10.3 ml/m2 in the CVS group while it was only 25.8 ± 6.4 ml/m2 in the control group which was statistically significant (P value= 0.002). Conclusion LAVI is a strong parameter that can be used to predict the occurrence of CVS in patients with sinus rhythm. Total (n = 2444) Acute CVS (n = 1222) No CVS (n = 1222) P-value Age (years) 61.1 ± 14.4 61.5 ± 12.4 0.75 Sex (Males) 806 (66%) 852 (70%) 0.65 Diabetes 655 (53.6%) 603 (49.3%) 0.6 Hypertension 702 (57.5%) 675 (55.2%) 0.55 Smoking 599 (49%) 564 (46.2%) 0.71 Dyslipidemia 310 (25.4%) 299 (24.5%) 0.81 Mean BP (mmHg) 122 ± 15 119 ± 17 0.88 Heart rate (bpm) 82 ± 16 85 ± 18 0.76 Hemoglobin (g/dl) 12.3 ± 1.3 12.9 ± 1.7 0.61 Platelets (103/l) 255 ± 110 235 ± 95 0.35 INR 1.15 ± 0.11 1.09 ± 0.18 0.75 Ejection fraction (%) 55 ± 12 51 ± 11 0.41 LAVI (ml/m2) 35 ± 10.3 25.8 ± 6.4 0.002* Results are represented as number (%) or mean ± standard deviation, BP = Blood Pressure, INR = International Normalization Ratio, * significant P value &lt; 0.05 Abstract P1506 Figure. Comparison between both groups

Sign in / Sign up

Export Citation Format

Share Document