THE COX-MAZE IV PROCEDURE FOR

LONE ATRIAL FIBRILLATION: A

SINGLE CENTER EXPERIENCE IN 100
CONSECUTIVE PATIENTS.
Atrial fibrillation (AF) is the most common
arrhythmia in the world with an increasing
incidence in our aging population. It is
associated with significant morbidity and
mortality secondary to its detrimental
sequelae.

AF accounts for about 25% of all

strokes in patients older than 80 years.

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DISCUSSION
 SURGICAL
TECHNIQUE
•CMP-IV was performed by •The heart is retracted and the
cardiopulmonary bypass left atrial appendage is removed.
with bicaval cannulation. The Through this opening, the bipolar
patient underwent a middle clamp was used to create an
sternotomy or a ablation line in one of the left
right minitoracotomy. pulmonary veins.

•Stimulation thresholds •A small left atriotomy

were measured from the
right and left lower was then performed
pulmonary veins, which and the remains of the
were then isolated by ablation lines were
placing the jaws of the
bipolar radiofrequency completed with the
ablation device in the bipolar forceps.
atrial tissue.
•After the ablation, electrical •In patients undergoing a
right minitoracotomy,
isolation was documented, stimulation was performed only
by stimulation of each from the right pulmonary veins.
pulmonary vein with a The patients were cooled to 34 °
stimulus force of 20 mA to C and the whole right atrial lesion
confirm the exit block was performed in the beating
heart.

•The set of left atrial •The cryoablation was

lesions was performed  used toconnect the is
under cardioplegic arrest thmus ablation line to
using cold blood the mitral ring.
cardioplegia.

•In patients who underwent a

right  minitoracotomy, the cryoablation
was applied more widely to complete
the posterior left atrial isolation and the
left atrial appendage was covered from
the inside.
1. Who introduced the cox-maze procedure?
R: The doctor Cox
2. How many patients underwent the study?
R: two hundred patients
3. What is atrial fibrillation?
QUESTIONS R: it's an arrhythmia
4. How much percentage does atrial
fibrillation represent in strokes?
R: twenty-five percentage
5. What diagnostic method were performed
on all intraoperative patients?
R: Transesophageal echocardiography

ARTICLE