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Higher F-wave frequency associates with poor procedural success rate after Maze procedure

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Abstract

Objectives

Persistent atrial fibrillation (AF) causes atrial remodeling, which causes myocardial fibrosis and micro-reentry. Fibrosis may reduce wave voltage and micro-reentry may enhance the dominant frequency (DF) of the F-wave. We investigated whether the DF predicts procedural success by the Maze procedure.

Methods

In 138 consecutive patients who underwent mitral valve surgery and a modified Cox-Maze III procedure for persistent AF in Nagoya University in 2002–2018, 96 (70%) were successfully cardioverted (group S); 42 had persistent or relapsed AF after surgery (group F). Patient data were compared between the groups. Cut-off values were determined by an ROC analysis and predictors of procedural success were evaluated. The DF was obtained from the F-wave of V1 by a high-speed Fourier analysis using the CEPAS software program.

Results

Group F showed a significantly larger LA diameter, better LVEF, lower F-wave voltage, higher DF, and longer duration of AF. The cut-off values were as follows: LA diameter, 56 mm; EF, 64.5%; F-wave voltage, 0.13 mV; DF, 7.3 Hz; and duration of AF, 44 months. Each factor showed statistical significance in a univariate analysis; DF lost significance in the multivariate analysis. The higher (DF ≥ 7.3 Hz) and lower voltage group (≤ 0.13 mV) showed the worst procedural success rate (36%), while the lower DF (< 7.3 Hz) and higher voltage group (> 0.13 mV) showed a good rate (86%).

Conclusions

The DF of the F-wave is a useful predictor of procedural success after the Maze procedure in addition to the voltage of F-wave.

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Abbreviations

AF:

Atrial fibrillation

DF:

Dominant frequency

LA:

Left atrial

LVEF:

Left ventricular ejection fraction

ECG:

Electrocardiogram

FFT:

Fast Fourier transform

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan

    Rena Usui, Masato Mutsuga, Yuji Narita, Yoshiyuki Tokuda, Sachie Terazawa, Hideki Ito, Wataru Uchida & Akihiko Usui

  2. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yasuya Inden & Toyoaki Murohara

Authors
  1. Rena Usui
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  2. Masato Mutsuga
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  3. Yuji Narita
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  4. Yoshiyuki Tokuda
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  5. Sachie Terazawa
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  6. Hideki Ito
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  7. Wataru Uchida
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  10. Akihiko Usui
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Correspondence to Rena Usui.

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Usui, R., Mutsuga, M., Narita, Y. et al. Higher F-wave frequency associates with poor procedural success rate after Maze procedure. Gen Thorac Cardiovasc Surg 70, 997–1004 (2022). https://doi.org/10.1007/s11748-022-01836-0

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  • DOI: https://doi.org/10.1007/s11748-022-01836-0

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