Problem after the MAZE operation

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Posted by Ozzi Nassar on September 30, 2002 at 10:23:06:

Hi Friends:

If you recall, after 5 years of Chronic Lone AF I had a sucessfull Maze operation on Sept. 13th 2001.

However, 10 Months after the operation after I moved to Cairo, Egypt, I developed a rapid heart beats, sever sweat, and fatigue.

The EKG and Holter Monitor showed a return to the AF. I went back on medication (Cordaron to regulate the heart beats, Concure to slow the heart rate, and Anticoagulant).

The last EKG and Holter Monitor seems to regulate the heart beats but not the fast heart rate. My local Dr. indicated that what I had is possibly an Atrial Flatter not AF.

Following is the comments of Dr. Mills of CC on my Holter Monitor Results:

From the reports you have sent, I think you have reverted to your usual sinus tachycardia with paroxysmal atrial fibrillation. I would:

1. not change the Cordarone dose,
2. continue the anti-coagulation with Coumadin, and
3. slowly increase the metoprolol, going first to 25 mg two times a day, about 12 hours apart.

The persistant rapid heart rates in the abscence of any structural heart disease suggest to me that the entire electrical system in your heart is somewhat
suspect. Given the very difficult problem of managing this with drugs when you are quite literally halfway around the world, I would seriously consider
ablation and implantation of a pacemaker with long-term anticoagulation as a more practical alternative.

I am planning to travel to CC in January for mapping and ablation.

1) Did any of the MAZER had similar problem (i.e a return of AFIB)?

2) If Yes, what is the rate of sucess of an ablation procedure after the MAZE?

3) Is it possible that the new problem was caused by Atrial Flatter ? If it is, what type of test is conducted that can tell the difference? (My understanding with Atrial Flatter that it is caused by one active cell and therefore abalation procedure is far more sucessful).

4) I hate the thought of a pacemaker with long-term anticoagulation as a more practical alternative, as sugessted by Dr. Mills. Any other alternative from any Mazer who had similar problem?

Thank you.


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