BACKGROUND: This study compares clinical results of the standard Maze III operation, a highly effective treatment for atrial fibrillation, to less complex variations of the Maze III operation utilizing unipolar and bipolar radiofrequency (RF) ablation and pulmonary vein isolation.
METHODS: Records were reviewed of 377 patients undergoing operations for treatment of atrial fibrillation at a single institution over a 10-year period. Standard Maze III was performed in 220 patients, bipolar RF Maze III in 64, unipolar RF Maze III in 61, and RF pulmonary vein isolation in 33. Electrocardiograms were obtained at discharge, 3, 6, and 12 month intervals. Chi-square test and pairwise comparisons were performed to determine significant associations between operative procedures and outcomes.
RESULTS: Mean age was 65.1 years (range 22-87). There were 11 hospital deaths (2.9%) and 7 deaths during follow-up. Most patients (89.4%, 337/377) had concomitant operations. EKG analysis was available in 320 patients at 3 months and 170 patients at 6 months (see table). Freedom from atrial fibrillation at 3 months was better after standard Maze III compared to other procedures (p < 0.005). At 6 months, there was no difference in freedom from atrial fibrillation among the procedures (p = 0.280).

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