Introduction
Atrial tachycardia (AT) and atrial
fibrillation (AF) commonly occur after cardiac surgery (CS), and Maze
procedure has been used to treat and prevent such
arrhythmias.1 The Maze techniques have been modified
over time. Originally, the cut-and-sew technique has been used. In
recent years, energy sources, such as radiofrequency (RF), cryo, and
Ultrasound (US), have been introduced into the
procedure.2-4 Typically, Cox III and Kosakai’s Maze
procedures use the cut-and-sew technique4, Maze IV
uses RF energy3, and CryoMaze2 uses
cryo energy, but Maze technique depends on operators and the facilities.
Surgical Maze has been recommended for maintaining sinus
rhythm,5 but the failure of the procedure may lead to
persistent atrial arrhythmias, which could result in embolism, heart
failure, and fatal events.6-8
Previously, the electrophysiological mechanisms of ATs after Maze
surgery have been reported by some institutions.3,9 However, few detailed studies have been made on
whether there is a relationship between gaps and AT/AF after various
Maze procedures. The purpose of this study was to investigate the
characteristics, electrophysiological findings, and outcomes of catheter
ablation (CA) of atrial arrhythmias after cut-and-sew, RF, or cryo Maze
procedures.